Individual
DR. MICHAEL ANTHONY EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(215) 707-3133
(215) 707-3945
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(215) 707-3133
(215) 707-3945
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
057799
GA
208600000X
Surgery Physician
223815
MA
208600000X
Surgery Physician
MD450548
PA
208600000X
Surgery Physician
Primary
ME136929
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
710203021A
—
GA
05
—
710203021B
—
GA
05
—
710203021C
—
GA
05
—
710203021D
—
GA
05
—
710203021E
—
GA
05
—
G57799
—
SC
01
—
P00423698
RAILROAD MEDICARE
GA
Enumeration date
05/11/2006
Last updated
08/31/2020
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