Provider Demographics
NPI:1174663967
Name:NORMAN R EDWARDS MD LTD
Entity Type:Organization
Organization Name:NORMAN R EDWARDS MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-873-0712
Mailing Address - Street 1:PO BOX 6694
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-0694
Mailing Address - Country:US
Mailing Address - Phone:757-874-0712
Mailing Address - Fax:757-874-0691
Practice Address - Street 1:610 THIMBLE SHOALS BLVD
Practice Address - Street 2:#404
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2526
Practice Address - Country:US
Practice Address - Phone:757-873-0712
Practice Address - Fax:757-873-0691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005388OtherANTHEM BCBS
VA6261264Medicaid
4211797OtherAETNA
2122353OtherCIGNA
B08327Medicare UPIN