Provider Demographics
NPI:1174895619
Name:FITZGIBBON, EDMOND JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:EDMOND
Middle Name:JOSEPH
Last Name:FITZGIBBON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:BLDG 49 RM 2A50
Mailing Address - Street 2:NEI, NIH
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-496-7144
Mailing Address - Fax:301-402-0511
Practice Address - Street 1:BLDG 49 RM 2A50
Practice Address - Street 2:NEI, NIH
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-496-7144
Practice Address - Fax:301-402-0511
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
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Provider Licenses
StateLicense IDTaxonomies
MDD39579207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology