Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD013626E | PA |
Y | 208600000X | Surgeon | MD013626E | PA |
NPI | 1013930528 |
---|---|
Provider Name | Dr. Joseph M Bednarek |
First Address | Philadelphia, PA 19134-4402 |
Second Address | Bristol, PA 19007-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006109770001 | (05) | PA |
B33499 | (02) | PA |