Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | MD60035970 | WA |
NPI | 1013906833 |
---|---|
Provider Name | Dr. Marshall D. Bedder |
First Address | Augusta, GA 30912-0004 |
Second Address | Augusta, GA 30912-5626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 07/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2001447 | (05) | WA |
8541336 | (05) | WA |
C92175 | (02) |