Provider Demographics
NPI:1194980789
Name:WAINWRIGHT EDWARDS, MARSHA (MD)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:WAINWRIGHT EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 SHORE FRONT PKWY
Mailing Address - Street 2:APT 6E
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-1811
Mailing Address - Country:US
Mailing Address - Phone:917-974-6701
Mailing Address - Fax:
Practice Address - Street 1:8400 SHORE FRONT PKWY
Practice Address - Street 2:APT 6E
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1811
Practice Address - Country:US
Practice Address - Phone:917-974-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT193770207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine