Provider Demographics
NPI:1760533822
Name:EDEBURN, GEORGE FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:FREDERICK
Last Name:EDEBURN
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 1:36 VAN ARTSDALEN DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1354
Mailing Address - Country:US
Mailing Address - Phone:215-369-2817
Mailing Address - Fax:
Practice Address - Street 1:36 VAN ARTSDALEN DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON CROSSING
Practice Address - State:PA
Practice Address - Zip Code:18977-1354
Practice Address - Country:US
Practice Address - Phone:215-369-2817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA555092085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology