Provider Demographics
NPI:1134199573
Name:SAYLOR, EDWARD MICHAEL
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:MICHAEL
Last Name:SAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 GLENSIDE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3769
Mailing Address - Country:US
Mailing Address - Phone:804-288-2762
Mailing Address - Fax:804-285-0088
Practice Address - Street 1:1800 GLENSIDE DR STE 105
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3769
Practice Address - Country:US
Practice Address - Phone:804-288-2762
Practice Address - Fax:804-285-0088
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027510207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1117900OtherCIGNA
VAP00601108OtherMEDICARE RAILROAD
VA1134199573Medicaid
VA631600OtherSOUTHERN HEALTH
VA5635772Medicaid
VA139784OtherANTHEM
VA302011OtherANTHEM BCBS
VA5635772Medicaid
VA1134199573Medicaid
VAP00601108OtherMEDICARE RAILROAD