Provider Demographics
NPI:1033479878
Name:EDWARDS, CHRISTOPHER OWEN (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:OWEN
Last Name:EDWARDS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GLEN COVE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4238
Mailing Address - Country:US
Mailing Address - Phone:207-301-5757
Mailing Address - Fax:207-301-5357
Practice Address - Street 1:4 GLEN COVE DR STE 201
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4238
Practice Address - Country:US
Practice Address - Phone:207-301-5757
Practice Address - Fax:207-301-5357
Is Sole Proprietor?:No
Enumeration Date:2012-05-28
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD291312084N0008X, 2084N0400X
LAMD.2080152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAMD.208015OtherNEUROLOGY