MEDICARE: DR. RONDA F GEDWARD EDD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1174861801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONDA F GEDWARD EDD

Provider Business Mailing Address
First Line	:	1096 REDAN TRAIL CT
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30088-2543
Country	:	US
Telephone Number	:	404-210-5680
Fax Number	:	678-476-9682

Provider Business Practice Location Address
First Line	:	1096 REDAN TRAIL CT
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30088-2543
Country	:	US
Telephone Number	:	404-210-5680
Fax Number	:	678-476-9682

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2013
Last Update Date	:	01/31/2013

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Directions to “ DR. RONDA F GEDWARD EDD” Practice Location

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