Individual
LORETTA I EDMONDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
310 MULLET RUN, MILFORD, DE 19963-5371
(302) 424-0600
(302) 422-6214
Mailing address
640 S. STATE STREET, POB 3RD FLOOR, DOVER, DE 19901
(302) 480-1688
(302) 480-9807
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C10004098
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000486401
—
DE
Enumeration date
11/30/2005
Last updated
01/30/2018
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