Individual
RANDOLPH ANTHONY EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1332 E 104TH ST, BROOKLYN, NY 11236-4508
(507) 279-2052
Mailing address
PO BOX 340581, BROOKLYN, NY 11234-0581
(507) 279-2052
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32957
MN
208600000X
Surgery Physician
MD60178868
WA
Other
Enumeration date
12/21/2005
Last updated
02/13/2014
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