Provider Demographics
NPI:1790775898
Name:GARVEY, EDMUND P (MD)
Entity Type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:P
Last Name:GARVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2222
Mailing Address - Country:US
Mailing Address - Phone:717-394-9821
Mailing Address - Fax:717-394-0175
Practice Address - Street 1:133 E FREDERICK ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2222
Practice Address - Country:US
Practice Address - Phone:717-394-9821
Practice Address - Fax:717-394-0175
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-021593-E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007457440002Medicaid
PA0007457440002Medicaid
PA003493EHYMedicare ID - Type Unspecified