Individual
DR. CHARLES S EDENFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
623 S HOUSTON LAKE RD STE 200, WARNER ROBINS, GA 31088-9094
(478) 923-6633
(478) 923-8444
Mailing address
2675 WINKLER AVE STE 200, FORT MYERS, FL 33901-9328
(877) 856-3774
(239) 599-2612
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
030052
GA
207RP1001X
Pulmonary Disease Physician
Primary
030052
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00354362D
—
GA
Enumeration date
06/07/2006
Last updated
03/03/2026
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