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Organization

DAVID A. EDMONSON, M.D., PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID A EDMONSON MD (MD/OWNER)
(518) 641-6936
Entity
Organization

Contact information

Practice address
319 S MANNING BLVD, SUITE 210, ALBANY, NY 12208-1742
(518) 641-6936
(518) 641-6939
Mailing address
PO BOX 194, ALBANY, NY 12201-0194
(518) 641-6936
(518) 641-6939

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
236674-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02733833
NY
01
1750440699
INDIVIDUAL NPI #
NY
Enumeration date
11/01/2007
Last updated
11/02/2007
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