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Individual

EDWARD SANFORD PURVIS II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2232 WILBORN AVENUE, PHYSICIANS PAVILION, SOUTH BOSTON, VA 24592-2936
(434) 517-0233
Mailing address
PO BOX 860, SOUTH BOSTON, VA 24592-0860
(434) 517-3590

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101053990
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007313501
VA
01
104303
OPTIMA
VA
01
462169
ANTHEM BC BS
VA
01
P00038731
RAILROAD MEDICARE
VA
Enumeration date
07/14/2005
Last updated
07/25/2018
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