| Doctor Name: | MR. EDWARD MICHAEL BULLARD |
| NPI Number: | 1386662666 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPA C |
| License Number: | 23008844 |
| Business Practice Address: | 2212 Penfield Rd Suite 200 Penfield, NY - 145261756 |
| Business Phone Number: | 5855988555 |
| Business Fax Number: | 5853881483 |
| Mailing Address: | 2212 Penfield Rd, Suite 200 PENFIELD |
| State: | NY |
| Postal Code: | 145261756 |
| Phone Number: | 5855988555 |
| Fax Number: | 5853881483 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 01/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 23008844 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |