Provider Demographics
NPI:1932788932
Name:EDWARDS, MICHAEL GERALD III (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GERALD
Last Name:EDWARDS
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD # MS 1045
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-1559
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD # MS 1045
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-3328
Practice Address - Country:US
Practice Address - Phone:913-588-1559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-11739207P00000X
IL125.078315208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine