Individual
DR. JOHN RANDALL EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8111 S EMERSON AVE # 105, INDIANAPOLIS, IN 46237-8601
(317) 528-5500
(317) 528-6316
Mailing address
PO BOX 781090, DETROIT, MI 48278-1090
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01072415A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250625400
—
FL
01
—
31512
BCBS
FL
01
—
370020210
RAILROAD MEDICARE
—
Enumeration date
06/02/2006
Last updated
09/20/2023
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