Individual
MARK DOUGLAS EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 N PARK TRL STE B, STOCKBRIDGE, GA 30281
(770) 507-0909
(770) 507-1919
Mailing address
1355 PEACHTREE ST NE STE 1600, ATLANTA, GA 30309-3276
(678) 223-7774
(678) 223-7799
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
48041
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
859232130A
—
GA
Enumeration date
10/31/2005
Last updated
09/05/2018
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