Provider Demographics
NPI:1407893035
Name:EDWARDS, PAUL D (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:EDWARDS
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 1:1589 CAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2915
Mailing Address - Country:US
Mailing Address - Phone:304-525-9131
Mailing Address - Fax:
Practice Address - Street 1:2561 THIRD AVENUE
Practice Address - Street 2:PEDIATRIC PLASTIC SURGERY/CRANIOFACIAL C
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:02570
Practice Address - Country:US
Practice Address - Phone:304-525-9131
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2095082086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery