Provider Demographics
NPI:1134364599
Name:EDWARDS, CLAIRE R (MD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:R
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:224-D CORNWALL STREET, NW.
Mailing Address - Street 2:SUITE 403
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3690
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:19500 SANDRIDGE WAY, SUITE 450
Practice Address - Street 2:
Practice Address - City:LEEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3694
Practice Address - Country:US
Practice Address - Phone:703-724-9474
Practice Address - Fax:571-346-1921
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP20789208600000X
VA0101253404208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1134364599Medicaid