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Individual

SUZANNE MARIE EDMUNDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200400030
NC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
200400030
NC
2080P0203X
Pediatric Critical Care Medicine Physician
200400030
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10057426
VA
01
135VP
BCBS
05
1810842000
WV
01
7368785
AETNA
01
803805
PARTNERS
05
89135VP
NC
01
D1218
MEDCOST
05
Q00030
SC
Enumeration date
12/13/2005
Last updated
06/29/2010
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