Provider Demographics
NPI:1578553426
Name:EDWARDS, ANITA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2027 LEBANON CHURCH RD
Mailing Address - Street 2:CENTURY III MEDICAL ASSOCIATES
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-2461
Mailing Address - Country:US
Mailing Address - Phone:412-655-6403
Mailing Address - Fax:412-655-6400
Practice Address - Street 1:2027 LEBANON CHURCH RD
Practice Address - Street 2:CENTURY III MEDICAL ASSOCIATES
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2461
Practice Address - Country:US
Practice Address - Phone:412-655-6403
Practice Address - Fax:412-655-6400
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD036477E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011177970007Medicaid
PA0011177970007Medicaid
PA514619R7RMedicare PIN