| Samuel M Edwards M D P A | |
|
750 W Plymouth Ave Deland FL 32720-3282 | |
| (386) 736-7244 | |
| (386) 736-8538 |
| Full Name | Samuel M Edwards M D P A |
|---|---|
| Speciality | Internal Medicine |
| Location | 750 W Plymouth Ave, Deland, Florida |
| Authorized Official Name and Position | Lynette A Tarnowski (OFFICE MANAGER) |
| Authorized Official Contact | 3867367244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel M Edwards M D P A 750 W Plymouth Ave Deland FL 32720-3282 Ph: (386) 736-7244 | Samuel M Edwards M D P A 750 W Plymouth Ave Deland FL 32720-3282 Ph: (386) 736-7244 |
| NPI Number | 1023394707 |
|---|---|
| Provider Enumeration Date | 10/26/2011 |
| Last Update Date | 10/26/2011 |
| Medicare PECOS PAC ID | 2062688369 |
|---|---|
| Medicare Enrollment ID | O20120109000786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023394707 | NPI | - | NPPES |
| 272821400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0066309 (Florida) | Primary |
| Provider Name | Samuel M Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386706000 PECOS PAC ID: 1951577253 Enrollment ID: I20120109000811 |
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