Provider Demographics
NPI:1174539159
Name:MUIR, EDWARD SIMMONS (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:SIMMONS
Last Name:MUIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT 913
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-261-0700
Mailing Address - Fax:901-261-0701
Practice Address - Street 1:6799 GREAT OAKS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38138-2588
Practice Address - Country:US
Practice Address - Phone:901-259-9794
Practice Address - Fax:901-259-9795
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-05-28
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Provider Licenses
StateLicense IDTaxonomies
TNMD018051207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN30321231Medicaid
TN3023123Medicaid
TN3023123Medicaid
TN30321231Medicare PIN
TN30321231Medicare PIN