Provider Demographics
NPI:1851822324
Name:GARNAND-PROCTOR, BETHANY (MD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:
Last Name:GARNAND-PROCTOR
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 1:111 CHAMBERS HILL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-7304
Mailing Address - Country:US
Mailing Address - Phone:717-709-7922
Mailing Address - Fax:
Practice Address - Street 1:830 5TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4224
Practice Address - Country:US
Practice Address - Phone:717-709-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-25
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD470270208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program