Provider Demographics
NPI:1831323203
Name:EDSON, KATHERINE P (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:P
Last Name:EDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ROANOKE ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-2428
Mailing Address - Country:US
Mailing Address - Phone:540-251-1394
Mailing Address - Fax:866-277-6049
Practice Address - Street 1:1600 ROANOKE ST
Practice Address - Street 2:SUITE D
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-2428
Practice Address - Country:US
Practice Address - Phone:540-251-1394
Practice Address - Fax:866-277-6049
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine