Provider Demographics
NPI:1336137009
Name:EDWARDS, ANDREW D (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:EDWARDS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4190
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:4017 DEVILS GLEN RD
Practice Address - Street 2:STE 100
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7221
Practice Address - Country:US
Practice Address - Phone:563-332-6387
Practice Address - Fax:563-332-9197
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2021-04-19
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Provider Licenses
StateLicense IDTaxonomies
IA23803207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA22557OtherWELLMARK HEALTH PLAN
IA01N3OtherJOHN DEERE HEALTH PLAN
A02636Medicare UPIN