MEDICARE: DAYVONNE UGENE EDWARDS

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1962157735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAYVONNE UGENE EDWARDS

Provider Business Mailing Address
First Line	:	2412 AINGER PL SE APT 116
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-3575
Country	:	US
Telephone Number	:	202-749-2398
Fax Number	:

Provider Business Practice Location Address
First Line	:	2412 AINGER PLACE SE
Second Line	:	APARTMENT 116
City	:	WASHINGTON
State	:	DC
Zip	:	20020-2002
Country	:	US
Telephone Number	:	202-749-2398
Fax Number	:

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

Provider Enumeration Date	:	02/19/2022
Last Update Date	:	02/19/2022

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Directions to “ DAYVONNE UGENE EDWARDS ” Practice Location

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