Individual
EDWARD HUNTER REDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 E 1300 N, LOGAN, UT 84341
(435) 792-6491
Mailing address
655 E 1300 N, LOGAN, UT 84341
(435) 792-6491
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
180675
UT
207R00000X
Internal Medicine Physician
Primary
180675-1205
UT
208600000X
Surgery Physician
180675-8905
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09706
—
UT
Enumeration date
07/11/2006
Last updated
10/29/2018
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