MEDICARE: DR. CHASTITY TAKOMA EDWARDS MD

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	207V00000X	Obstetrics & Gynecology Physician	MD-17096	HI
2	207V00000X	Obstetrics & Gynecology Physician	D66469	MD
3	207V00000X	Obstetrics & Gynecology Physician	2017-02404	NC

General Provider Information

NPI Number	:	1437283231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHASTITY TAKOMA EDWARDS MD

Provider Business Mailing Address
First Line	:	16 HOSPITAL DR
Second Line	:	STE C
City	:	YORK
State	:	ME
Zip	:	03909-1041
Country	:	US
Telephone Number	:	808-242-6464
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 MEDICAL PARK DR
Second Line	:
City	:	FRANKLIN
State	:	NC
Zip	:	28734-2632
Country	:	US
Telephone Number	:	828-349-8288
Fax Number	:	828-349-8289

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	01/08/2019

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