Individual
NICHOLAS M EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MPH
Contact information
Practice address
155 RADIO DR, WOODBURY, MN 55125-2619
(952) 831-8742
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
47394
WI
2080S0010X
Pediatric Sports Medicine Physician
35.094808
OH
2080S0010X
Pediatric Sports Medicine Physician
Primary
48608
MN
Other
Enumeration date
04/20/2006
Last updated
06/12/2023
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