Provider Demographics
NPI:1235111238
Name:PAGE, EDWIN HOWARD JR (MD)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:HOWARD
Last Name:PAGE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1709 BEAVER GRADE RD
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-3103
Mailing Address - Country:US
Mailing Address - Phone:724-773-3498
Mailing Address - Fax:724-773-4648
Practice Address - Street 1:1000 DUTCH RIDGE RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-9727
Practice Address - Country:US
Practice Address - Phone:724-773-3498
Practice Address - Fax:724-773-4648
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA021358E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine