Individual
THOMAS R EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
20794
MN
207Q00000X
Family Medicine Physician
Primary
20794
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080014086
MET
MN
01
—
176P3ED
BC/BS
MN
05
—
634287600
—
MN
01
—
HP22543
HEALTHPARTNERS
MN
01
—
P00264010
RR MEDICARE
MN
Enumeration date
01/30/2006
Last updated
03/20/2019
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