=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134364599
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLAIRE R EDWARDS MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2008
-----------------------------------------------------
Last Update Date | 11/29/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19500 SANDRIDGE WAY, SUITE 450
-----------------------------------------------------
City | LEEESBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20176-3694
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-724-9474
-----------------------------------------------------
Fax | 571-346-1921
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 224-D CORNWALL STREET, NW. SUITE 403
-----------------------------------------------------
City | LEESBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20176-3690
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-737-6010
-----------------------------------------------------
Fax | 703-443-8643
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | P20789
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 0101253404
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------