Provider Demographics
NPI:1265505531
Name:EDWARDS, ALBERT M II (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:M
Last Name:EDWARDS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-0005
Mailing Address - Country:US
Mailing Address - Phone:770-328-6398
Mailing Address - Fax:404-443-0690
Practice Address - Street 1:4039 ATLANTA ST STE 100
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2666
Practice Address - Country:US
Practice Address - Phone:770-241-1326
Practice Address - Fax:770-679-3939
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2021-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA30053207QH0002X, 208VP0000X
GA030053207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C33546Medicare UPIN
GA00360258AMedicaid