EDGAR MAEYENS (NPI# 1871574947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871574947 |
| Entity Type | Individual |
| Full Name | EDGAR MAEYENS |
| Credential | MD |
| Practice Address |
375 Park Ave Suite 5 Coos Bay OR 97420-2242 |
| Mailing Address |
1793 13th St Se Salem OR 97302-2541 |
| Practice Telephone | 5412677543 |
| Practice Fax Number | 5412672076 |
| Mailing Telephone | 5033628385 |
| Mailing Fax Number | 5033628435 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2017-12-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD08528 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
375 PARK AVE SUITE 5 |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420-2242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144607961 | Creative Roots Therapy LLC | Counselor | 375 Park Ave, Suite B, Coos Bay, OR 97420 | 2015-04-30 |
| 1043463391 | Erin Elizabeth Spier | Counselor | 375 Park Ave, Suite 2, Coos Bay, OR 97420 | 2008-10-30 |
| 1043398159 | Edgar Maeyens Jr Md PC | Specialist | 375 Park Ave, Suite 5, Coos Bay, OR 97420-2244 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447713573 | Dermatology Health Specialists, PC | Dermatology | 1693 Sw Chandler Ave Ste 250, Bend, OR 97702-3231 | 2019-04-06 |
| 1972913259 | Lindsey Fix | Dermatology | 1605 G St, Springfield, OR 97477 | 2014-05-07 |
| 1558515494 | Jay Y Park Md, PC | Dermatology | 360 S Garden Way Ste 230, Eugene, OR 97401-8173 | 2008-11-05 |
| 1780846501 | Bend Memorial Clinic PC | Dermatology | 2600 Ne Neff Rd, Bend, OR 97701-6337 | 2008-07-02 |
| 1700081742 | Richard I. Ecker | Dermatology | 706 Ne Evans St, Mcminnville, OR 97128-3926 | 2007-06-19 |
| 1396845814 | Parwathi Vasudeva Paniker | Dermatology | 3600 N Interstate Ave, Portland, OR 97227-1106 | 2006-09-24 |
| 1184643249 | William J Delgado | Dermatology | 2705 Ne Conners Ave, Bend, OR 97701-6904 | 2006-07-19 |
| 1205805405 | Stephen N Snow | Dermatology | 3600 N Interstate Ave, Dermatology/mohs Surg Central Interstate Medical Office, Portland, OR 97227-1106 | 2006-03-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.