Provider Demographics
NPI:1841784691
Name:EDWARDS, AMANDA-GAY A (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA-GAY
Middle Name:A
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 BELCREST RD APT 1319
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2968
Mailing Address - Country:US
Mailing Address - Phone:202-487-1753
Mailing Address - Fax:
Practice Address - Street 1:3 WASHINGTON CIR NW STE 305
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2311
Practice Address - Country:US
Practice Address - Phone:202-540-7641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical