Healthcare Provider Details
I. General information
NPI: 1124937735
Provider Name (Legal Business Name): DONNA EDWARDS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
116 FOXHUNT DR # 118
BEAR DE
19701-2535
US
IV. Provider business mailing address
8 MARVILO AVE
WILMINGTON DE
19805-2038
US
V. Phone/Fax
- Phone: 302-239-1933
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | I4-0010152 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: