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Individual

CHARLES C EDWARDS, II

Active
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Individual

CHARLES C EDWARDS, II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
D0058977
MD
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
D0058977
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
408414400
MD
01
F 482 /0003
BLUE CHOICE
MD
01
LZ51/617648-01,02,03
BC /BS OF MD
MD
Enumeration date
08/30/2006
Last updated
03/07/2008
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