Provider Demographics
NPI:1386601995
Name:EDWARDS THOMAS, NONA LEE (MD)
Entity type:Individual
Prefix:
First Name:NONA
Middle Name:LEE
Last Name:EDWARDS THOMAS
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35546207V00000X
OH35-064332207V00000X
MS17452207V00000X
PAMD459249207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0968270OtherOH MEDICAID MOLINA
WV3810016019Medicaid
OH310917085222OtherOHIO MEDICAID CARESOURCE
OH00000028920OtherOHIO MEDICAID UNISON
OH0968270Medicaid
PA10322273Medicaid
MD114672600Medicaid
TN3867334Medicaid
OHTH4060292Medicare PIN
OH0968270OtherOH MEDICAID MOLINA