Provider Demographics
NPI:1780148494
Name:BEDWARD, CORNEL T (RRT)
Entity type:Individual
Prefix:MR
First Name:CORNEL
Middle Name:T
Last Name:BEDWARD
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 THE NEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLES CITY
Mailing Address - State:VA
Mailing Address - Zip Code:23030-4424
Mailing Address - Country:US
Mailing Address - Phone:804-426-1314
Mailing Address - Fax:
Practice Address - Street 1:9301 THE NEW RD
Practice Address - Street 2:
Practice Address - City:CHARLES CITY
Practice Address - State:VA
Practice Address - Zip Code:23030-4424
Practice Address - Country:US
Practice Address - Phone:804-426-1314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01170071882279P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Diagnostics