Provider Demographics
NPI:1720363831
Name:EDWARDS, KEVIN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:JOSEPH
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5665 NEW NORTHSIDE DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5831
Mailing Address - Country:US
Mailing Address - Phone:404-645-7840
Mailing Address - Fax:404-645-7570
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:EMERGENCY MEDICINE
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-7926
Practice Address - Fax:973-290-7202
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2014-06-09
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Provider Licenses
StateLicense IDTaxonomies
FL119327207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine