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Individual

EDWARD WESTFALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01086140A
IN
207Y00000X
Otolaryngology Physician
125.069145
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/28/2016
Last updated
07/09/2021
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