Provider Demographics
NPI:1801058433
Name:EDWARDS, ANNA M (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:M
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1200 W WHITE RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-4988
Mailing Address - Country:US
Mailing Address - Phone:877-668-5621
Mailing Address - Fax:
Practice Address - Street 1:26 N ARSENAL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-3808
Practice Address - Country:US
Practice Address - Phone:317-423-0130
Practice Address - Fax:317-423-0608
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067537A207P00000X, 207Q00000X
IN11014535A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201024640Medicaid
IN000001060003OtherANTHEM PROVIDER NUMBER - FAMILY MEDICINE
IN201024640OtherHEALTHNET
IN000000765306OtherANTHEM
IN000001058928OtherANTHEM PROVIDER NUMBER - URGENT CARE
INM400047153Medicare PIN
IN000001058928OtherANTHEM PROVIDER NUMBER - URGENT CARE
INM400071133Medicare PIN
INM400051225Medicare PIN
IN000001060003OtherANTHEM PROVIDER NUMBER - FAMILY MEDICINE
IN000000765306OtherANTHEM