Provider Demographics
NPI:1699005603
Name:BEDWELL, MARIA DENIES (BS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DENIES
Last Name:BEDWELL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-8531
Mailing Address - Country:US
Mailing Address - Phone:812-486-9258
Mailing Address - Fax:
Practice Address - Street 1:1914 RIDGE DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-8531
Practice Address - Country:US
Practice Address - Phone:812-486-9258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker