Provider Demographics
NPI:1407012479
Name:BEDI, KIRANJIT KAUR (OD)
Entity Type:Individual
Prefix:DR
First Name:KIRANJIT
Middle Name:KAUR
Last Name:BEDI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12019 LEATHERBARK WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1983
Mailing Address - Country:US
Mailing Address - Phone:202-329-9809
Mailing Address - Fax:
Practice Address - Street 1:6635 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2361
Practice Address - Country:US
Practice Address - Phone:410-766-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2105152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist