Individual
MR. JEAN SIMON JOEL EDOUARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
NJDCATEMP-000588
NJ
246ZC0007X
Surgical Assistant
21-308
WI
363A00000X
Physician Assistant
000430-P.A
PR
363A00000X
Physician Assistant
Primary
8276
AZ
363A00000X
Physician Assistant
NJDCATEMP-00291
NJ
363A00000X
Physician Assistant
PA01253
RI
Other
Enumeration date
09/05/2019
Last updated
10/06/2022
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