Individual
DR. DAVID A EDMONDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
512 S 28TH AVE, WAUSAU, WI 54401-4147
(715) 847-2021
(715) 847-2325
Mailing address
512 S 28TH AVE, WAUSAU, WI 54401-4147
(715) 847-2021
(715) 847-2325
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
45109
WI
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
45109
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008906261N
HUMANA
—
Enumeration date
05/15/2006
Last updated
04/13/2020
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