Provider Demographics
NPI:1841542503
Name:GEORGE, EDGAR B (MD)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:B
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1580 SANTA BARBARA BLVD
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6827
Mailing Address - Country:US
Mailing Address - Phone:352-259-2159
Mailing Address - Fax:352-259-5731
Practice Address - Street 1:938 SAXON BLVD STE D
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8305
Practice Address - Country:US
Practice Address - Phone:352-259-2159
Practice Address - Fax:352-259-5731
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME135094208D00000X
ZZME135094208D00000X
PR13,114-I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice