Provider Demographics
NPI:1154438257
Name:EDWARDS, JAMES JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5500 RIDGE ROAD
Mailing Address - Street 2:#208
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129
Mailing Address - Country:US
Mailing Address - Phone:440-884-7181
Mailing Address - Fax:440-884-7738
Practice Address - Street 1:5500 RIDGE ROAD
Practice Address - Street 2:#208
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129
Practice Address - Country:US
Practice Address - Phone:440-884-7181
Practice Address - Fax:440-884-7738
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037510207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0800572OtherUNITED HEALTHCARE INS
OH0394989Medicaid
000000118992OtherANTHEM INS COMPANY
311205732026OtherCARESOURCE INS COMPANY
9340006OtherCIGNA INS COMPANY
OH0394989Medicaid
D67753Medicare UPIN