Provider Demographics
NPI:1245938919
Name:BEDFORD, CHRISTOPHER WESLEY
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WESLEY
Last Name:BEDFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9348 ALMAR PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-4872
Mailing Address - Country:US
Mailing Address - Phone:412-445-2329
Mailing Address - Fax:
Practice Address - Street 1:9348 ALMAR PL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-4872
Practice Address - Country:US
Practice Address - Phone:412-445-2329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027139363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health