Provider Demographics
NPI:1225117013
Name:DOAN, EDWIN L (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:L
Last Name:DOAN
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 1:2228 WEST RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-6441
Mailing Address - Country:US
Mailing Address - Phone:757-676-8373
Mailing Address - Fax:
Practice Address - Street 1:312 CEDAR LAKES DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-8380
Practice Address - Country:US
Practice Address - Phone:757-546-0031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001238111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation