Provider Demographics
NPI:1306819065
Name:SCOTT A. EDWARDS, MD & ASSOC. P.A.
Entity Type:Organization
Organization Name:SCOTT A. EDWARDS, MD & ASSOC. P.A.
Other - Org Name:PENINSULA CANCER CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-543-1943
Mailing Address - Street 1:200A E VINE ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5516
Mailing Address - Country:US
Mailing Address - Phone:410-543-1943
Mailing Address - Fax:410-543-0658
Practice Address - Street 1:200A E VINE ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5516
Practice Address - Country:US
Practice Address - Phone:410-543-1943
Practice Address - Fax:410-543-0658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045485174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty