Provider Demographics
NPI:1679992887
Name:EDWARDS, COLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CANTON ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3524
Mailing Address - Country:US
Mailing Address - Phone:603-622-3623
Mailing Address - Fax:513-475-8228
Practice Address - Street 1:30 CANTON ST STE 2
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3524
Practice Address - Country:US
Practice Address - Phone:603-622-3623
Practice Address - Fax:513-475-8228
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.024576207Y00000X
NH19799207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology