E EDWARD PROCTOR (NPI# 1790771103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790771103 |
Entity Type | Individual |
Full Name | E EDWARD PROCTOR |
Credential | MD |
Practice Address |
755 Walther Rd Lawrenceville GA 30045 |
Mailing Address |
755 Walther Rd Lawrenceville GA 30045-8725 |
Practice Telephone | 7709620399 |
Practice Fax Number | 7709950533 |
Mailing Telephone | 7709620399 |
Mailing Fax Number | 7709950533 |
Enumeration Date | 2005-09-21 |
Last Update Date | 2019-04-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
32976 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 00430328C | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
755 Walther Rd, Lawrenceville, GA 30045 | 7709620399 | 7709950533 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215334560 | E Jean Proctor | Physician Assistant | 940 E 3rd St Ste 103, Casper, WY 82601-3200 | 2014-12-02 |
Street Address |
755 WALTHER RD |
City | LAWRENCEVILLE |
State | GA |
Zip Code | 30045 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578563953 | Khalid Jalil Hayat | Internal Medicine | 755 Walther Rd, Lawrenceville, GA 30046 | 2005-07-27 |
1821612938 | Northside Cv Professional Services LLC | Internal Medicine | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2020-06-04 |
1275095341 | Laura Maria Gonzalez | Nurse Practitioner | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2019-04-05 |
1275012379 | Giftson Joseph | Physician Assistant | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2018-08-09 |
1669983169 | Mihaela Ionashku | Nurse Practitioner | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2017-10-24 |
1689197378 | Cvg Physicians Group, LLC | Internal Medicine | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2017-07-25 |
1720446644 | Mijung Han | Nurse Practitioner | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2016-02-06 |
1346617990 | Margaret Trupiano | Nurse Practitioner | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2015-08-31 |
1508260183 | Rafael Florin Rosu | Nurse Practitioner | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2014-10-10 |
1306185491 | Gwinnett Cardiology Services LLC | Internal Medicine | 755 Walther Rd, Lawrenceville, GA 30046-8725 | 2013-02-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
Find all providers in zip 30045 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083269146 | Helio Malinverni Md Pa | Internal Medicine | 100 Federal City Rd Ste C-103, Lawrenceville, NJ 08648-1664 | 2019-08-06 |
1952698664 | Paul H Chew | Internal Medicine | 1 Brookdale Dr, Lawrenceville, NJ 08648-5545 | 2011-07-01 |
1821247156 | Mohammad Shafiq Choudhry | Internal Medicine | 1737 Princeton Ave, Lawrenceville, NJ 08648-4515 | 2008-09-10 |
1447434469 | Samir Suresh Shah | Internal Medicine | 3140 Princeton Pike Fl 2, Lawrenceville, NJ 08648-2330 | 2007-12-27 |
1841404233 | Jim Mathew John | Internal Medicine | 755 Walther Rd # 325-0159, Lawrenceville, GA 30046 | 2007-05-09 |
1356358741 | Henry A Liberman | Internal Medicine | 721 Wellness Way Ste 210, Lawrenceville, GA 30046-3304 | 2006-08-01 |
1376531517 | William Edward Costanzo | Internal Medicine | 3140 Princeton Pike, 2nd Floor, Lawrenceville, NJ 08648-2306 | 2005-10-12 |
1043206477 | Michael A. Lipsitt | Internal Medicine | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2005-09-21 |
1285620625 | Sheila Edith Hunter Woodhouse | Internal Medicine | 771 Old Norcross Rd Ste 105, Lawrenceville, GA 30046-4977 | 2005-09-21 |
1578563953 | Khalid Jalil Hayat | Internal Medicine | 755 Walther Rd, Lawrenceville, GA 30046 | 2005-07-27 |
Find all providers in LAWRENCEVILLE |
City | LAWRENCEVILLE |
Zip Code | 30045 |
Please comment or provide details below to improve the information on E EDWARD PROCTOR.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.