Provider Demographics
NPI:1225181217
Name:KAHN, EDGAR MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:MICHAEL
Last Name:KAHN
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 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:STE 310
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-952-2111
Mailing Address - Fax:
Practice Address - Street 1:71 S FLANNAGAN AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266
Practice Address - Country:US
Practice Address - Phone:276-883-8042
Practice Address - Fax:276-883-8044
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1012621302084P0800X
TN554702084P0800X
NH77262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHC84812Medicare UPIN
NHRE1127Medicare ID - Type UnspecifiedMEDICARE PROVIDER
NHRE3213Medicare ID - Type UnspecifiedMEDICARE GROUP