Basic Information
| Provider Information | |||||||||
| NPI: | 1720228364 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLISON R. EDWARDS, MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14300 GALLANT FOX LN | ||||||||
| Address2: | SUITE # 226 | ||||||||
| City: | BOWIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207154003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012628900 | ||||||||
| FaxNumber: | 3012620915 | ||||||||
| Practice Location | |||||||||
| Address1: | 14300 GALLANT FOX LN | ||||||||
| Address2: | SUITE # 226 | ||||||||
| City: | BOWIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207154003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012628900 | ||||||||
| FaxNumber: | 3012620915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2009 | ||||||||
| LastUpdateDate: | 02/23/2009 | ||||||||
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| AuthorizedOfficialLastName: | EDWARDS | ||||||||
| AuthorizedOfficialFirstName: | ALLISON | ||||||||
| AuthorizedOfficialMiddleName: | REGINA | ||||||||
| AuthorizedOfficialTitleorPosition: | CARDIOLOGIST/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3012628900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.