Provider Demographics
NPI:1962709386
Name:EDWARDS, PAUL DEAN JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DEAN
Last Name:EDWARDS
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BELLHAVEN WAY
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-1500
Mailing Address - Country:US
Mailing Address - Phone:843-422-2839
Mailing Address - Fax:
Practice Address - Street 1:20 HATTON PL
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-4202
Practice Address - Country:US
Practice Address - Phone:843-342-7451
Practice Address - Fax:843-342-7051
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist