Provider Demographics
NPI:1760571491
Name:EDMONDS, CHERYL F (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:F
Last Name:EDMONDS
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:4910 MASSACHUSETTS AVE NW
Mailing Address - Street 2:SUITE 217
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4300
Mailing Address - Country:US
Mailing Address - Phone:202-244-1553
Mailing Address - Fax:202-244-2192
Practice Address - Street 1:4910 MASSACHUSETTS AVE NW
Practice Address - Street 2:SUITE 217
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4300
Practice Address - Country:US
Practice Address - Phone:202-244-1553
Practice Address - Fax:202-244-2192
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD14258208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCMD14258OtherSTATE LICENSE