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EDWARD STEVENS URBAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
580 W 8TH ST, UFJP NEUROLOGY, JACKSONVILLE, FL 32209-6533
(904) 244-3960
(904) 244-3425
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME93755
FL
2084N0400X
Neurology Physician
056495
GA
2084N0400X
Neurology Physician
Primary
ME93755
FL
2084N0600X
Clinical Neurophysiology Physician
ME93755
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2732467-00
FL
05
315904028A
GA
Enumeration date
03/14/2006
Last updated
08/05/2010
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