Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD.208015 | LA |
NPI | 1033479878 |
---|---|
Provider Name | Christopher Owen Edwards |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70121-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2012 |
Last Update Date | 29/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD.208015 | NEUROLOGY (01) | LA |