Individual
EDMUND CHARLES HASKINS
Active
Individual
EDMUND CHARLES HASKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20040177A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100376730A
—
IN
01
—
680011626
MEDICARE RAILROAD
IN
01
—
P01157050
RR MEDICARE PTAN
IN
Enumeration date
08/19/2005
Last updated
05/21/2014
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