Provider Demographics
NPI:1255889002
Name:EDWARDS, SINAY P
Entity type:Individual
Prefix:DR
First Name:SINAY
Middle Name:P
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:SINAY
Other - Middle Name:P
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTHER
Mailing Address - Street 1:295 SAINT CLAIR DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-3254
Mailing Address - Country:US
Mailing Address - Phone:229-733-1087
Mailing Address - Fax:229-439-4306
Practice Address - Street 1:295 SAINT CLAIR DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-3254
Practice Address - Country:US
Practice Address - Phone:229-733-1087
Practice Address - Fax:229-439-4306
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA918695171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor