Basic Information
| Provider Information | |||||||||
| NPI: | 1295719136 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EDGE | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 MASSACHUSETTS AVE NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200026227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025467159 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 60 O ST NW | ||||||||
| Address2: | SOME MEDICAL CLINIC | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200011259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027978806 | ||||||||
| FaxNumber: | 2022650927 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2005 | ||||||||
| LastUpdateDate: | 09/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD10275 | DC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.