Provider Demographics
NPI:1265645907
Name:BEDOYA, JOSEANGEL DAMIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEANGEL
Middle Name:DAMIAN
Last Name:BEDOYA
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 1:301 BROWNHILL CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2659
Mailing Address - Country:US
Mailing Address - Phone:707-714-1179
Mailing Address - Fax:
Practice Address - Street 1:3345 COBB PKWY NW STE 800
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-8346
Practice Address - Country:US
Practice Address - Phone:678-919-7200
Practice Address - Fax:678-919-7210
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63630207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine