Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D0018793 | MD |
Y | 207XS0117X | Orthopaedic Spine Surgeon | D0018793 | MD |
NPI | 1033229588 |
---|---|
Provider Name | Charles C Edwards |
First Address | Baltimore, MD 21263-0594 |
Second Address | Baltimore, MD 21202-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 07/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
305191900 | (05) | MA |
F 482 / 0002 | BLUE CHOICE (01) | MD |
LZ51/310240-03 | BC/BS OF MD (01) | MD |
LZ51/310240-07,08,09 | BC/BS OF MD (01) | MD |