Provider Demographics
NPI:1427112788
Name:MOVIUS, EDWARD G (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:G
Last Name:MOVIUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:1396 PICCARD DR
Practice Address - Street 2:KAISER PERMANENTE SHADY GROVE MEDICAL CENTER
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4302
Practice Address - Country:US
Practice Address - Phone:301-548-5805
Practice Address - Fax:301-548-5780
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD30250207RE0101X
DCMD17664207RE0101X
VA0101230515207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
C88430Medicare UPIN
007080M92Medicare ID - Type Unspecified