Edward Sidorov, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

43326 Issued in SC

Practice address

1942 Montague Avenue Ext
Greenwood, SC 29649-9045

Phone

(864) 223-7679

NPI assigned

Jan 19, 2022

Last updated

Jan 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1043962244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 HENRY CULLINS RD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215016",
            "telephone_number": "425-773-9727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 MONTAGUE AVENUE EXT",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296499045",
            "telephone_number": "864-223-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOROV",
        "first_name": "EDWARD",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "43326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Shoop, DNP, CRNA
• John P Short, DO
• Steven Shugart
• Alexandra Ann Shurling, M.D.
• Wayne B Sida, MD
• Katherine Sikes, PHARMD
• Carlos Henrique Silva, MD
• Tara Ann Simmons, COTA/L
• David Wayne Simons, PA-C
• Locke E Simons

• Pharmacist in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.