Individual provider · NPI-1

Loretta I Edmondson, M.D.

Family Medicine · Milford, DE

NPI number1871577189
StatusActive
Last updated in NPPESJan 30, 2018

Details

NPI
1871577189
Entity type
Individual (NPI-1)
Name
Loretta I Edmondson
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Nov 30, 2005
Last updated
Jan 30, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineC10004098DEYes

Practice location

310 Mullet Run
Milford, DE 19963-5371

Phone 302-424-0600 · Fax 302-422-6214

Mailing address

640 S. State Street, Pob 3rd Floor
Dover, DE 19901

Phone 302-480-1688 · Fax 302-480-9807

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