Individual
GEORGIA A. EDE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
270 TEATICKET HWY, UNIT 1B, TEATICKET, MA 02536-5671
(508) 540-5735
(508) 540-5840
Mailing address
270 TEATICKET HWY, UNIT 1B, TEATICKET, MA 02536-5671
(508) 540-5735
(508) 540-5840
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
202976
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202976
TUFTS
MA
01
—
J25170
BC/BS
MA
Enumeration date
10/28/2005
Last updated
07/08/2007
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