Provider Demographics
NPI:1255325148
Name:BIGGERSTAFF, EDWARD DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:DANIEL
Last Name:BIGGERSTAFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5354 REYNOLDS ST
Mailing Address - Street 2:SUITE 518
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6007
Mailing Address - Country:US
Mailing Address - Phone:912-355-7717
Mailing Address - Fax:912-355-0979
Practice Address - Street 1:5354 REYNOLDS ST
Practice Address - Street 2:SUITE 518
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6007
Practice Address - Country:US
Practice Address - Phone:912-355-7717
Practice Address - Fax:912-355-0979
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAGA 023427207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00241964BMedicaid
GA00241964BMedicaid