Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | MD448592 | PA |
Y | 2084V0102X | Vascular Neurology | MD448592 | PA |
NPI | 1003950411 |
---|---|
Provider Name | Adam B. Edwards |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-6224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2007 |
Last Update Date | 22/06/2021 |