Individual
MICIA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
315 S MANNING BLVD, ALBANY, NY 12208-1707
(518) 525-8600
(518) 525-6545
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
331187
NY
208M00000X
Hospitalist Physician
Primary
331187
NY
390200000X
Student in an Organized Health Care Education/Training Program
64440
—
Other
Enumeration date
03/27/2021
Last updated
02/10/2025
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