Edwards-Conrad, Penelope

Edwards-Conrad, Penelope is an sole proprietor health care provider with primary practice located at 2935 N Ashley St D116, Valdosta GA 31602-1777. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Edwards-Conrad, Penelope can be contacted via phone (229) 244-1192.

Contact Information

Primary practice address
2935 N Ashley St D116 Valdosta GA 31602-1777
Phone: (229) 244-1192
Fax: (229) 244-1195
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X GA45205 Georgia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X ME73941 Florida

Profile Details

NPI number 1720074602
LBN Legal business name Edwards-Conrad, Penelope
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2005
Last updated Apr 10th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720074602 NPPES
Georgia MEDICAID 00813062B

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