Provider Demographics
NPI:1558433722
Name:POON, EDWARD D (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:D
Last Name:POON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 BROOKS LANE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:JEFFERSON
Mailing Address - State:PA
Mailing Address - Zip Code:15025
Mailing Address - Country:US
Mailing Address - Phone:412-469-1660
Mailing Address - Fax:412-469-8972
Practice Address - Street 1:1200 BROOKS LN
Practice Address - Street 2:SUITE 240
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3747
Practice Address - Country:US
Practice Address - Phone:412-469-1660
Practice Address - Fax:412-469-8972
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2020-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD065616-L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG63708Medicare UPIN
PA015513MUVMedicare ID - Type Unspecified