Individual
DR. PENELOPE EDWARDS-CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2935 N ASHLEY ST, D116, VALDOSTA, GA 31602-1777
(229) 244-1192
(229) 244-1195
Mailing address
3338 COUNTRY CLUB RD STE L, VALDOSTA, GA 31605-7425
(229) 244-1191
(229) 244-1195
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
GA45205
GA
2084N0400X
Neurology Physician
ME73941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00813062B
—
GA
Enumeration date
09/26/2005
Last updated
04/10/2010
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