Individual
MICHAEL EDMUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
973 MICA DRIVE, SUITE 201, CARSON CITY, NV 89705-7255
(775) 783-6190
(775) 783-6191
Mailing address
973 MICA DR, SUITE 201, CARSON CITY, NV 89705-7255
(775) 783-6190
(775) 783-6191
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6786
NV
207X00000X
Orthopaedic Surgery Physician
G75392
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002013131
—
NV
01
—
200026572
MEDICARE RAILROAD
NV
01
—
CC7065
BCBS
NV
Enumeration date
11/02/2005
Last updated
07/22/2021
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