Provider Demographics
NPI:1336287481
Name:FUCHS, EDWARD J (PA-C)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:FUCHS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 CANON WAY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5762
Mailing Address - Country:US
Mailing Address - Phone:410-614-8762
Mailing Address - Fax:410-955-9708
Practice Address - Street 1:600 NORTH WOLFE STREET
Practice Address - Street 2:HARVEY 502
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:410-614-8762
Practice Address - Fax:410-955-9708
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0000663363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical