Basic Information
| Provider Information | |||||||||
| NPI: | 1174531503 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDINGER | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | MARTIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178379315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705224110 | ||||||||
| FaxNumber: | 5705224120 | ||||||||
| Practice Location | |||||||||
| Address1: | 905 US HIGHWAY 522 | ||||||||
| Address2: | |||||||||
| City: | SELINSGROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703726102 | ||||||||
| FaxNumber: | 5703726110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD044729E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01954002 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 1268C3AK | 01 | PA | GEISINGER | OTHER | 600441 | 01 | PA | BLUE SHIELD | OTHER | P00092014 | 01 | PA | RAILROAD MEDICARE | OTHER | 01954002 | 01 | PA | KEYSTONE | OTHER | 12044440003 | 05 | PA | MEDICAID | E04994 | 01 | PA | HEALTH AMERICA | OTHER |