Provider Demographics
NPI:1538466206
Name:EDWARDS, CHARLES LOUIS (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LOUIS
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 TOOK PL
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6482
Mailing Address - Country:US
Mailing Address - Phone:843-245-4787
Mailing Address - Fax:
Practice Address - Street 1:1137 TOOK PL
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6482
Practice Address - Country:US
Practice Address - Phone:843-245-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMLDO1685207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine