Provider Demographics
NPI:1831608918
Name:EMILY SHONK EDWARDS DO PC
Entity type:Organization
Organization Name:EMILY SHONK EDWARDS DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:SHONK
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-569-2834
Mailing Address - Street 1:PO BOX 234
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24402-0234
Mailing Address - Country:US
Mailing Address - Phone:540-569-2834
Mailing Address - Fax:540-322-4987
Practice Address - Street 1:2009 N AUGUSTA ST STE B
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2436
Practice Address - Country:US
Practice Address - Phone:540-765-8177
Practice Address - Fax:877-852-8642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202642207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1366641011OtherINDIVIDUAL NPI