Stallworth, Edwina

Stallworth, Edwina is an individual health care provider with primary practice located at 19853 Outer Dr Ste 110 , Dearborn MI 48124-2044. She recently has only one registered license in Eye and Vision Services Providers / Technician/Technologist, which is considered as her primary health care specialty. Stallworth, Edwina can be contacted via phone (313) 406-5056.

Contact Information

Primary practice address
19853 Outer Dr Ste 110 Dearborn MI 48124-2044
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Technician/Technologist 156F00000X

Profile Details

NPI number 1962007344
LBN Legal business name Stallworth, Edwina
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2020
Last updated Oct 5th, 2023 - about last year

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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