Individual
DR. EDWARD DISTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2409 N PATTERSON ST STE 310, VALDOSTA, GA 31602-2512
(229) 433-8160
(229) 244-2707
Mailing address
2409 N PATTERSON ST STE 310, VALDOSTA, GA 31602-2512
(229) 433-8160
(220) 244-2707
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
007087
AZ
207RC0000X
Cardiovascular Disease Physician
Primary
91531
GA
Other
Enumeration date
04/01/2015
Last updated
08/23/2022
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