Provider Demographics
NPI:1831149921
Name:BEHMER, EDWARD ANTHONY (DPM)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:ANTHONY
Last Name:BEHMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2587
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-2587
Mailing Address - Country:US
Mailing Address - Phone:256-533-3624
Mailing Address - Fax:256-534-9176
Practice Address - Street 1:929 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-533-3624
Practice Address - Fax:256-534-9176
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
70009OtherBLUE CROSS BLUE SHIELD
70009OtherBLUE CROSS BLUE SHIELD