Provider Demographics
NPI:1205285483
Name:ROONEY, EDWARD MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MICHAEL
Last Name:ROONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1296 E POLSTON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-5217
Mailing Address - Country:US
Mailing Address - Phone:208-625-6700
Mailing Address - Fax:208-625-6701
Practice Address - Street 1:1296 E POLSTON AVE STE C
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-5217
Practice Address - Country:US
Practice Address - Phone:208-625-6700
Practice Address - Fax:208-625-6701
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2021-01235207X00000X
MI4301109695207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery