Provider Demographics
NPI:1164582789
Name:BEDELL, ALAN NICHOLS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:NICHOLS
Last Name:BEDELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 MARSHALL AVE.
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15214
Mailing Address - Country:US
Mailing Address - Phone:412-321-6995
Mailing Address - Fax:412-322-5405
Practice Address - Street 1:530 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15214-3016
Practice Address - Country:US
Practice Address - Phone:412-321-6995
Practice Address - Fax:412-322-5405
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027718E2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011350330005Medicaid
PA0011350330003Medicaid
PA0011350330004Medicaid
PA0011350330003Medicaid