Healthcare Provider Details

I. General information

NPI: 1962771071
Provider Name (Legal Business Name): CHRISTINE EDWARDS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4971 ARLINGTON CENTRE BLVD
COLUMBUS OH
43220-2910
US

IV. Provider business mailing address

4971 ARLINGTON CENTRE BLVD
COLUMBUS OH
43220-2910
US

V. Phone/Fax

Practice location:
  • Phone: 614-246-6900
  • Fax: 614-246-6909
Mailing address:
  • Phone: 614-246-6900
  • Fax: 614-246-6909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35068059
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: