Provider Demographics
NPI:1255341962
Name:EDWARDS, ANDREA GAYE (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:GAYE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1663 DOMINICAN WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1556
Mailing Address - Country:US
Mailing Address - Phone:831-475-8002
Mailing Address - Fax:831-475-8580
Practice Address - Street 1:1663 DOMINICAN WAY STE 210
Practice Address - Street 2:SUITE 210
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1556
Practice Address - Country:US
Practice Address - Phone:831-475-8002
Practice Address - Fax:831-475-8580
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83742207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology