Provider Demographics
NPI:1518209436
Name:EDWARDS, JONATHAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:JOSEPH
Last Name:EDWARDS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:DIVISION OF CARDIOLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4319
Mailing Address - Country:US
Mailing Address - Phone:215-590-3274
Mailing Address - Fax:215-590-5825
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:DIVISION OF CARDIOLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-3274
Practice Address - Fax:215-590-5825
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2016-11-15
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Provider Licenses
StateLicense IDTaxonomies
PAMD4590772080P0202X
PAMT2103012080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology