Provider Demographics
NPI:1174636351
Name:HELMAN, EDWARD ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ALLEN
Last Name:HELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 ROYAL AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6127
Mailing Address - Country:US
Mailing Address - Phone:541-770-5188
Mailing Address - Fax:541-245-2506
Practice Address - Street 1:1017 ROYAL AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6127
Practice Address - Country:US
Practice Address - Phone:541-770-5188
Practice Address - Fax:541-245-2506
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD09729207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR086637Medicaid
ORR0000WCJXTMedicare PIN
OR086637Medicaid