Provider Demographics
NPI:1760455737
Name:WHELAN, EDWARD J III (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:WHELAN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:460 MALL BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4801
Mailing Address - Country:US
Mailing Address - Phone:912-644-5300
Mailing Address - Fax:912-644-3369
Practice Address - Street 1:210 E DERENNE AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6736
Practice Address - Country:US
Practice Address - Phone:912-644-5300
Practice Address - Fax:912-644-5260
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2017-01-04
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Provider Licenses
StateLicense IDTaxonomies
GA024373207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00344561BMedicaid
GA20BBFNQMedicare ID - Type Unspecified
GAD31320Medicare UPIN
D31320Medicare UPIN