Organization
PROSPECT FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DREW JAMESON EDWARDS M.D. (OWNER)
(203) 758-5660
Entity
Organization
Contact information
Practice address
115 WATERBURY RD., PROSPECT, CT 06712
(203) 758-5660
Mailing address
115 WATERBURY RD., PO BOX 7038, PROSPECT, CT 06712
(203) 758-5660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G1897306
OXFORD GROUP ID
CT
Enumeration date
12/12/2006
Last updated
08/22/2020
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