Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2014-01615 | NC |
NPI | 1003104092 |
---|---|
Provider Name | Tabitha M Bedini |
First Address | Raeford, NC 28376-7977 |
Second Address | Raeford, NC 28376-7977 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2011 |
Last Update Date | 16/08/2014 |