Individual
DR. EDWARD C HENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1135 LAKE ST STE 2, GIRARD, PA 16417-1049
(814) 774-3155
(814) 456-2375
Mailing address
1202 STATE ST, ERIE, PA 16501-1914
(814) 454-4530
(814) 456-2375
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD485353
PA
207R00000X
Internal Medicine Physician
MD485353
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2020
Last updated
07/14/2025
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