Provider Demographics
NPI:1083750400
Name:EDWARDS, DAVID CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHRISTOPHER
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4033 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5525
Mailing Address - Country:US
Mailing Address - Phone:504-324-5617
Mailing Address - Fax:504-324-5618
Practice Address - Street 1:4033 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5525
Practice Address - Country:US
Practice Address - Phone:504-324-5617
Practice Address - Fax:504-324-5618
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1364111N00000X, 111NS0005X
MS1082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4J647Medicare ID - Type Unspecified
LAV05380Medicare UPIN