MEDICARE: C Y EDWARDS MD PC

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	12986	NV

General Provider Information

NPI Number	:	1891011417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C Y EDWARDS MD PC

Provider Business Mailing Address
First Line	:	PO BOX 400310
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89140-0310
Country	:	US
Telephone Number	:	702-672-9982
Fax Number	:

Provider Business Practice Location Address
First Line	:	3376 S EASTERN AVE
Second Line	:	STE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3380
Country	:	US
Telephone Number	:	702-672-9982
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHERYL YVONNE EDWARDS
Credential	:	M.D.
Telephone Number	:	702-672-9982

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	06/15/2010

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