Individual
JONATHAN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BON SECOURS MARY IMMACULATE HOSPITAL, PATHOLOGY DEPT, 2 BERNARDINE DR, NEWPORT NEWS, VA 23602
(240) 678-5454
Mailing address
150 KINGSLEY LN, NORFOLK, VA 23505-4602
(866) 759-4528
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101269509
VA
Other
Enumeration date
08/26/2014
Last updated
05/13/2022
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