Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 036148912 | IL |
NPI | 1003362153 |
---|---|
Provider Name | Anuja Bedi |
First Address | Austin, TX 78722-1750 |
Second Address | Urbana, IL 61801-2529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2016 |
Last Update Date | 01/04/2021 |