Provider Demographics
NPI:1942237367
Name:BEDELL, DAVID T (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:BEDELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1631 PHOENIX BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5545
Mailing Address - Country:US
Mailing Address - Phone:770-997-8516
Mailing Address - Fax:770-991-9014
Practice Address - Street 1:1631 PHOENIX BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5545
Practice Address - Country:US
Practice Address - Phone:770-997-8516
Practice Address - Fax:770-991-9014
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA0131122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAB28894Medicare UPIN