Individual
DR. DAVID EDGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 MONROE AVE NE, GRAND RAPIDS, MI 49505-3397
(616) 364-5295
(616) 365-3804
Mailing address
3000 MONROE AVE NE, GRAND RAPIDS, MI 49505-3397
(616) 364-5295
(616) 365-3804
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301041461
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4296539
—
MI
01
—
DE041461
BCBS OF MICHIGAN
MI
Enumeration date
07/05/2006
Last updated
07/08/2007
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