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General NPI Number Information
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NPI Number | 1467895839
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Entity Type | Individual
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Provider Name | ALICE R EDWARDS D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2013
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 6161 KEMPSVILLE CIR STE 315
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City | NORFOLK
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State | VA
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Zip | 23502-3935
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Country | US
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Telephone | 757-461-5400
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Fax | 757-461-3305
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Provider Business Mailing Address
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Address Line | 675 NELSON RISING LN
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0003
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Country | US
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Telephone |
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Fax | 631-444-2894
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 0102208982
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License Number State | VA
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