Individual
GREG W EDENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 BRUSHY CREEK RD, EASLEY, SC 29642-2200
(864) 306-9661
(864) 306-8560
Mailing address
104 ASHMORE CT, LIBERTY, SC 29657-9299
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18754
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080173716
RAILROAD MEDICARE
SC
05
—
187540
—
SC
Enumeration date
04/14/2006
Last updated
10/18/2007
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