Individual
HANNIBAL EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19814 TOMAHAWK RD, APPLE VALLEY, CA 92307-5054
(760) 242-1903
Mailing address
PO BOX 1153, APPLE VALLEY, CA 92307-0020
(760) 242-1903
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
52552
GA
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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