Individual
DR. CHARLES STEPHEN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4075 OLD WESTERN ROW RD, LINDNER CENTER OF HOPE, MASON, OH 45040-3104
(513) 536-4673
Mailing address
4075 OLD WESTERN ROW RD, LINDNER CENTER OF HOPE, MASON, OH 45040-3104
(513) 536-4673
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
092117
OH
2084P0804X
Child & Adolescent Psychiatry Physician
16873
WV
2084P0804X
Child & Adolescent Psychiatry Physician
25933
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115170000
—
WV
01
—
0879536
MEDICAID
OH
01
—
64698905
MEDICAID
KY
Enumeration date
08/28/2006
Last updated
08/25/2008
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