Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | MD456310 | PA |
Y | 2081P2900X | Pain Medicine | D80197 | MD |
NPI | 1144512161 |
---|---|
Provider Name | Christopher Thomas Bednarek |
First Address | Owings Mills, MD 21117-4295 |
Second Address | Nottingham, MD 21236-4991 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2011 |
Last Update Date | 04/01/2017 |