Provider Demographics
NPI:1649387416
Name:EDWARDSON, MATTHEW ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALLEN
Last Name:EDWARDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10 CENTER DR
Mailing Address - Street 2:ROOM B1D-733, MSC 1063
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-1063
Mailing Address - Country:US
Mailing Address - Phone:301-435-9321
Mailing Address - Fax:301-480-0413
Practice Address - Street 1:8600 OLD GEORGETOWN RD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1422
Practice Address - Country:US
Practice Address - Phone:301-896-4003
Practice Address - Fax:301-896-4002
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2012-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD600919192084N0400X
MDD00747762084N0400X
DCMD0409602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology