Provider Demographics
NPI:1043391410
Name:EDWARDS, MICHAEL C (MD, FACS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:C
Last Name:EDWARDS
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Gender:M
Credentials:MD, FACS
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Mailing Address - Street 1:8530 W. SUNSET ROAD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113
Mailing Address - Country:US
Mailing Address - Phone:702-822-2100
Mailing Address - Fax:702-822-2105
Practice Address - Street 1:8530 W. SUNSET ROAD
Practice Address - Street 2:SUITE 130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:702-822-2100
Practice Address - Fax:702-822-2105
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2014-04-15
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Provider Licenses
StateLicense IDTaxonomies
NV8542208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVH95307Medicare UPIN