TERENCE SHAUN EDGAR MD NPI 1679506091

NPI Information

NPI: 1679506091
Provider Name: TERENCE SHAUN EDGAR, MD
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Individual

Specialization: Neurology with Special Qualifications in Child Neurology

Organization: ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS

PECOS Registration: Yes

Address:
1821 S WEBSTER AVE
GREEN BAY, WI
ZIP 54301
Phone: (920) 496-4700
Get Directions

Terence Shaun Edgar, MD is a neurology with special qualifications in child neurology psychiatry neurology in Green Bay, WI with 40 years of experience. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. Terence Shaun Edgar, MD NPI is 1679506091. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1821 S WEBSTER AVE
GREEN BAY, WI
ZIP 54301-253
Phone: (920) 496-4700

The NPI 1679506091 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 7/28/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	52201	MINNESOTA	No
2	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	34917	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	32117600	MEDICAID	WISCONSIN
2	130001484	MEDICARE PIN	MINNESOTA
3	F72259	MEDICARE UPIN
4	ENROLLED	MEDICAID	MINNESOTA
5	ENROLLED	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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