Provider Demographics
NPI:1740482017
Name:SMITH, EDWARD CHARLES (RDCS)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:CHARLES
Last Name:SMITH
Suffix:
Gender:M
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50313-4136
Mailing Address - Country:US
Mailing Address - Phone:515-865-4023
Mailing Address - Fax:
Practice Address - Street 1:3303 6TH AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-4136
Practice Address - Country:US
Practice Address - Phone:515-865-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography