Provider Demographics
NPI:1275574048
Name:BEDI, GAURI C (MD)
Entity Type:Individual
Prefix:
First Name:GAURI
Middle Name:C
Last Name:BEDI
Suffix:
Gender:F
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:PO BOX 64075
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:227 SAINT PAUL PL
Practice Address - Street 2:5TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2001
Practice Address - Country:US
Practice Address - Phone:410-332-9330
Practice Address - Fax:410-347-1175
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045264208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD014500900Medicaid
MDKT93ST / 685860-04OtherBC / BS OF MD
MDS186 / 0010OtherBLUECHOICE
MDS186 / 0010OtherBLUECHOICE
165L / A 277Medicare ID - Type Unspecified