Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 26250 | GA |
NPI | 1003870767 |
---|---|
Provider Name | Dr. Edward (e.d.) Douglas Culverhouse |
First Address | Montgomery, AL 36123-5019 |
Second Address | Warner Robins, GA 31093-3431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
224545 | STATE MERIT (01) | GA |
D39670 | (02) | GA |