Provider Demographics
NPI:1891489449
Name:BEDSIDE PHYSICIANS LLC
Entity Type:Organization
Organization Name:BEDSIDE PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JABULANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDILE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-633-0088
Mailing Address - Street 1:1700 NORTHSIDE DRIVE NW
Mailing Address - Street 2:SUITE A7 PMB 1627
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318
Mailing Address - Country:US
Mailing Address - Phone:513-633-0088
Mailing Address - Fax:
Practice Address - Street 1:1700 NORTHSIDE DRIVE NW
Practice Address - Street 2:SUITE A7 PMB 1627
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318
Practice Address - Country:US
Practice Address - Phone:513-633-0088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty