| Doctor Name: | DR. EDWIN CREWS DOUGLASS |
| NPI Number: | 1063628741 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD04774L |
| Business Practice Address: | 5 Develon Rd Melrose Park, PA - 190273154 |
| Business Phone Number: | 2156354473 |
| Business Fax Number: | |
| Mailing Address: | 5 Develon Rd, MELROSE PARK |
| State: | PA |
| Postal Code: | 190273154 |
| Phone Number: | 2156354473 |
| Fax Number: | |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080P0207X |
| License Number: | MD04774L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Pediatric Hematology-Oncology |
| Taxonomy Definition: | A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |