Edmondson, David A
Edmondson, David A is an individual health care provider with primary practice located at 512 S 28Th Ave , Wausau WI 54401-4147. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy, Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology. Allopathic & Osteopathic Physicians / Allergy is his primary health care specialty. Edmondson, David A can be contacted via phone (715) 847-2021.Contact Information
Primary practice address
512 S 28Th Ave
Wausau WI 54401-4147
Phone: (715) 847-2021
Fax: (715) 847-2325
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy | 207KA0200X | 45109 | Wisconsin |
| Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology | 207KI0005X | 45109 | Wisconsin |
Profile Details
| NPI number | 1124079033 |
|---|---|
| LBN Legal business name | Edmondson, David A |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | Apr 13th, 2020 - about 4 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 | 1124079033 | NPPES |
| Other | 008906261N | HUMANA |
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