Stark, Edward
Stark, Edward is an individual health care provider with primary practice located at 500 Medical Center Blvd Suite 220, Lawrenceville GA 30046. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Stark, Edward can be contacted via phone (770) 963-2451.Contact Information
Primary practice address
500 Medical Center Blvd Suite 220
Lawrenceville GA 30046
Phone: (770) 963-2451
Fax: (770) 962-0017
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 041680 | Georgia |
Profile Details
| NPI number | 1093727166 |
|---|---|
| LBN Legal business name | Stark, Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2006 |
| Last updated | Mar 7th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093727166 | NPPES |
| Georgia | Other | 340015407 | RAILROAD MEDICARE |
| Georgia | MEDICAID | 000707891G | RAILROAD MEDICARE |
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