Edgar, Terence Shaun

Edgar, Terence Shaun is an individual health care provider with primary practice located at 1821 S Webster Ave , Green Bay WI 54301-2253. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is his primary health care specialty. Edgar, Terence Shaun can be contacted via phone (920) 496-4700.

Contact Information

Primary practice address
1821 S Webster Ave Green Bay WI 54301-2253
Phone: (920) 496-4700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X 34917 Wisconsin
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 52201 Minnesota

Profile Details

NPI number 1679506091
LBN Legal business name Edgar, Terence Shaun
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2006
Last updated Jul 28th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679506091 NPPES
Iowa MEDICAID ENROLLED
Iowa MEDICAID 32117600
Iowa MEDICAID ENROLLED

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