Provider Demographics
NPI:1013393685
Name:EDWARDS, DAVID ROSS
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ROSS
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 GOLDENVIEW DR.
Mailing Address - Street 2:
Mailing Address - City:WEST KELOWNA
Mailing Address - State:BC - BRITISH COLUMBIA
Mailing Address - Zip Code:V4T1Y7
Mailing Address - Country:CA
Mailing Address - Phone:250-768-8785
Mailing Address - Fax:
Practice Address - Street 1:GARTREE MEDICAL CLINIC
Practice Address - Street 2:#510-4400-32ND ST.
Practice Address - City:VERNON
Practice Address - State:BC
Practice Address - Zip Code:V1T9H2
Practice Address - Country:CA
Practice Address - Phone:250-545-9112
Practice Address - Fax:250-545-7556
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24038207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine