Individual ProviderMegan Marie EdisonPediatricsAllopathic & Osteopathic PhysiciansPractice Address1200 56th St SW, C/O Brookville Pediatric & Internal Medicine, Pc, Wyoming, MI 49509-9704(616) 243-5707PECOS EnrollmentBased on the most recent information from CMS, provider Megan Marie Edison does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1780657478Provider TypeIndividualFull NameEdison, Megan MarieCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date2/11/2006Last Updated12/17/2007Contact InformationPractice LocationPractice Address1200 56th St SW, C/O Brookville Pediatric & Internal Medicine, Pc, Wyoming, MI 49509-9704Phone(616) 243-5707Fax(616) 243-1170Mailing LocationMailing Address8485 Algoma Ave, C/O Brookville Pediatric & Internal Medicine, Pc, Rockford, MI 49341Phone(616) 243-5707Fax(616) 243-1170Provider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense4301086893MichiganProvider IdentifiersIDDescriptionIssuerID11108809DescriptionOtherIssuerCAQH #Michigan