Provider Demographics
NPI:1124361134
Name:TORREY, EDWIN FULLER
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:FULLER
Last Name:TORREY
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 1:6204 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2642
Mailing Address - Country:US
Mailing Address - Phone:301-229-5619
Mailing Address - Fax:
Practice Address - Street 1:6204 RIDGE DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2642
Practice Address - Country:US
Practice Address - Phone:301-229-5619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD-145522084P0800X
MDD145522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry