Provider Demographics
NPI:1245367457
Name:EDELMAN, ANDREW SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SCOTT
Last Name:EDELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BUSINESS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-3431
Mailing Address - Country:US
Mailing Address - Phone:215-444-8153
Mailing Address - Fax:215-957-0563
Practice Address - Street 1:800 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-3407
Practice Address - Country:US
Practice Address - Phone:215-444-8153
Practice Address - Fax:215-957-0563
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045879-L207ZI0100X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01505232Medicaid
PAED705990Medicare ID - Type Unspecified
PA01505232Medicaid