Provider Demographics
NPI:1265771232
Name:BEDI, FERNAND MEL
Entity type:Individual
Prefix:
First Name:FERNAND
Middle Name:MEL
Last Name:BEDI
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 1:5732 TIBARON LN APT 2
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-8801
Mailing Address - Country:US
Mailing Address - Phone:812-236-9889
Mailing Address - Fax:
Practice Address - Street 1:105 GOLDEN GATE PLZ
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-2875
Practice Address - Country:US
Practice Address - Phone:419-893-5533
Practice Address - Fax:419-893-5158
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03132241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist