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Individual

DR. EDWARD GAYNOR RUPERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,P.A.

Contact information

Practice address
8000 KNOLLWOOD ST, BRANDYWINE, MD 20613-7656
(301) 372-1689
(301) 372-1689
Mailing address
8000 KNOLLWOOD ST, BRANDYWINE, MD 20613-7656
(301) 372-1689

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
D0021364
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3521
BCBSNCA
DC
01
7114
BCBS OF MD
MD
Enumeration date
04/06/2007
Last updated
09/11/2009
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