Provider Demographics
NPI:1891011417
Name:C Y EDWARDS MD PC
Entity Type:Organization
Organization Name:C Y EDWARDS MD PC
Other - Org Name:WOMENS HEALTH CENTER OF LAS VEGAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-672-9982
Mailing Address - Street 1:PO BOX 400310
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-0310
Mailing Address - Country:US
Mailing Address - Phone:702-672-9982
Mailing Address - Fax:
Practice Address - Street 1:3376 S EASTERN AVE
Practice Address - Street 2:STE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3380
Practice Address - Country:US
Practice Address - Phone:702-672-9982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12986207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE88921Medicare UPIN
NVBU047ZMedicare PIN