Proctor, E Edward
Proctor, E Edward is an individual health care provider with primary practice located at 755 Walther Rd , Lawrenceville GA 30045. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Proctor, E Edward can be contacted via phone (770) 962-0399.Contact Information
Primary practice address
755 Walther Rd
Lawrenceville GA 30045
Phone: (770) 962-0399
Fax: (770) 995-0533
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 32976 | Georgia |
Profile Details
| NPI number | 1790771103 |
|---|---|
| LBN Legal business name | Proctor, E Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2005 |
| Last updated | Apr 1st, 2019 - about 5 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 | 1790771103 | NPPES |
| Georgia | MEDICAID | 00430328C |
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