Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 3209 | SC |
NPI | 1033227772 |
---|---|
Provider Name | Dr. William Miller Edwards |
First Address | Spartanburg, SC 29302 |
Second Address | Spartanburg, SC 29302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 08/07/2007 |