Provider Demographics
NPI:1588648794
Name:REEDY, EDWARD ADISON (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ADISON
Last Name:REEDY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 DOUBLE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:PIKE ROAD
Mailing Address - State:AL
Mailing Address - Zip Code:36064-3891
Mailing Address - Country:US
Mailing Address - Phone:240-462-9800
Mailing Address - Fax:334-356-0634
Practice Address - Street 1:8160 AUM DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7001
Practice Address - Country:US
Practice Address - Phone:334-676-5292
Practice Address - Fax:334-260-8734
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL144013207ZF0201X
GA87109207ZF0201X
MDD0055313207ZF0201X
VA0101222881207ZP0102X
ALMD.35612207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology