Provider Demographics
NPI:1245299213
Name:BEDELL, LINDA (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:BEDELL
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 1:9205 E US HIGHWAY 223
Mailing Address - Street 2:PO BOX 86
Mailing Address - City:BLISSFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49228-9665
Mailing Address - Country:US
Mailing Address - Phone:517-486-5456
Mailing Address - Fax:517-486-0226
Practice Address - Street 1:9205 E US HIGHWAY 223
Practice Address - Street 2:
Practice Address - City:BLISSFIELD
Practice Address - State:MI
Practice Address - Zip Code:49228-9665
Practice Address - Country:US
Practice Address - Phone:517-486-5456
Practice Address - Fax:517-486-0226
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI383492398OtherTAX ID #
MI8004601642OtherBCBS
MI414523010Medicaid
MI0P03930Medicare ID - Type Unspecified
MI383492398OtherTAX ID #