Individual
E EDWARD PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
755 WALTHER RD, LAWRENCEVILLE, GA 30045
(770) 962-0399
(770) 995-0533
Mailing address
755 WALTHER RD, LAWRENCEVILLE, GA 30045-8725
(770) 962-0399
(770) 995-0533
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
32976
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00430328C
—
GA
Enumeration date
09/21/2005
Last updated
04/01/2019
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