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Individual

DR. RANDALL C EDGELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-4864
(314) 977-4878
Mailing address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
(314) 977-4864
(314) 977-4878

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
036145444
IL
2084V0102X
Vascular Neurology Physician
Primary
036145444
IL
2084V0102X
Vascular Neurology Physician
2007015340
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205461205
MO
Enumeration date
10/13/2006
Last updated
07/27/2023
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