Individual
EDWARD I DVORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 TELEPHONE RD, PASCAGOULA, MS 39567
(228) 762-4483
(228) 769-0406
Mailing address
2525 TELEPHONE RD, PASCAGOULA, MS 39567
(228) 762-4483
(228) 769-0406
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15891
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00339814
—
MS
01
—
P00054513
RAILROAD MEDICARE
MS
Enumeration date
07/27/2006
Last updated
05/02/2022
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