MEDICARE: TERESA EDWARDS MD PLC

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	207L00000X	Anesthesiology Physician	27258	AZ

General Provider Information

NPI Number	:	1306876586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERESA EDWARDS MD PLC

Provider Business Mailing Address
First Line	:	PO BOX 39179
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85069-9179
Country	:	US
Telephone Number	:	602-395-0718
Fax Number	:	602-277-8146

Provider Business Practice Location Address
First Line	:	7878 N 16TH ST STE 250
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4478
Country	:	US
Telephone Number	:	602-395-0718
Fax Number	:	602-277-8146

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LINDA HAMELIN
Credential	:
Telephone Number	:	602-308-7817

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/21/2022

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