| Doctor Name: | DR. EDWARD E BRIDGES |
| NPI Number: | 1306060017 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 0101241508 |
| Business Practice Address: | 559 Vincent Street Attn: 21 Amds / Sgpf-aerospace Medicine Peterson Afb, CO - 809141540 |
| Business Phone Number: | 7195561260 |
| Business Fax Number: | 8668677926 |
| Mailing Address: | 559 Vincent Street, Attn: 21 Amds / Sgpf-aerospace Medicine PETERSON AFB |
| State: | CO |
| Postal Code: | 809141540 |
| Phone Number: | 7195561260 |
| Fax Number: | 8668677926 |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 11/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101241508 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |