Individual
EDWARD C ADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3999 DUTCHMANS LN STE 7B, LOUISVILLE, KY 40207-4742
(502) 896-4711
(502) 896-4791
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
21649
KY
208600000X
Surgery Physician
Primary
21649
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049917
ANTHEM PIN #
KY
05
—
201048670
—
IN
01
—
50034543
PASSPORT
KY
05
—
64216492
—
KY
01
—
P01034888
RAILROAD MEDICARE
KY
Enumeration date
03/31/2006
Last updated
08/27/2021
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