Edge, Mark Douglas
Edge, Mark Douglas is an individual health care provider with primary practice located at 150 N Park Trl Ste B , Stockbridge GA 30281. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Edge, Mark Douglas can be contacted via phone (770) 507-0909.Contact Information
Primary practice address
150 N Park Trl Ste B
Stockbridge GA 30281
Phone: (770) 507-0909
Fax: (770) 507-1919
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 48041 | Georgia |
Profile Details
| NPI number | 1750372777 |
|---|---|
| LBN Legal business name | Edge, Mark Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Sep 5th, 2018 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750372777 | NPPES |
| Georgia | MEDICAID | 859232130A |
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