Provider Demographics
NPI:1356493134
Name:EDWARDS, FRANKLIN DOLAN (RPH)
Entity type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:DOLAN
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BLACK DUCK DR.
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617
Mailing Address - Country:US
Mailing Address - Phone:410-758-3274
Mailing Address - Fax:410-758-1714
Practice Address - Street 1:102 COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617
Practice Address - Country:US
Practice Address - Phone:410-758-1715
Practice Address - Fax:410-758-1714
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1184723942Medicare UPIN