Provider Demographics
NPI:1437283231
Name:EDWARDS, CHASTITY TAKOMA (MD)
Entity type:Individual
Prefix:DR
First Name:CHASTITY
Middle Name:TAKOMA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHASITY
Other - Middle Name:TAKOMA
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:16 HOSPITAL DR
Mailing Address - Street 2:STE C
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1041
Mailing Address - Country:US
Mailing Address - Phone:808-242-6464
Mailing Address - Fax:
Practice Address - Street 1:56 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2632
Practice Address - Country:US
Practice Address - Phone:828-349-8288
Practice Address - Fax:828-349-8289
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-17096207V00000X
MDD66469207V00000X
NC2017-02404207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology