Provider Demographics
NPI:1225181217
Name:KAHN, EDGAR MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:MICHAEL
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2325
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-2325
Mailing Address - Country:US
Mailing Address - Phone:603-356-3100
Mailing Address - Fax:603-356-7421
Practice Address - Street 1:71 S FLANNAGAN AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266
Practice Address - Country:US
Practice Address - Phone:276-883-8042
Practice Address - Fax:276-883-8044
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH77262084P0800X
VA1012621302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHC84812Medicare UPIN
NHRE1127Medicare ID - Type UnspecifiedMEDICARE PROVIDER
NHRE3213Medicare ID - Type UnspecifiedMEDICARE GROUP