Individual
DR. SUPAKUNYA EDMONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS9620
FL
2084N0400X
Neurology Physician
Primary
0102201767
VA
2084N0400X
Neurology Physician
2022046492
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
01/04/2006
Last updated
05/14/2026
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