Provider Demographics
NPI:1720228364
Name:ALLISON R. EDWARDS, MD PA
Entity Type:Organization
Organization Name:ALLISON R. EDWARDS, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-262-8900
Mailing Address - Street 1:14300 GALLANT FOX LN
Mailing Address - Street 2:SUITE # 226
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4003
Mailing Address - Country:US
Mailing Address - Phone:301-262-8900
Mailing Address - Fax:301-262-0915
Practice Address - Street 1:14300 GALLANT FOX LN
Practice Address - Street 2:SUITE # 226
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4003
Practice Address - Country:US
Practice Address - Phone:301-262-8900
Practice Address - Fax:301-262-0915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty