Provider Demographics
NPI:1881623320
Name:POTTER, EDGER VERDAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:EDGER
Middle Name:VERDAN
Last Name:POTTER
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2562
Mailing Address - Country:US
Mailing Address - Phone:202-722-0122
Mailing Address - Fax:202-722-0123
Practice Address - Street 1:3326 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2562
Practice Address - Country:US
Practice Address - Phone:202-722-0122
Practice Address - Fax:202-722-0123
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD9565207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD260891000Medicaid
DC023634400Medicaid
DC409003P77Medicare PIN
DC023634400Medicaid