Doctor Name: | MR. DANIEL J BEDECKI |
NPI Number: | 1063462414 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 01032307B |
Business Practice Address: | 1024 S 6th St Ste 204 Terre Haute, IN - 47807 |
Business Phone Number: | 8122347128 |
Business Fax Number: | 8122310104 |
Mailing Address: | 1024 S 6th St, Ste 204 TERRE HAUTE |
State: | IN |
Postal Code: | 47807 |
Phone Number: | 8122347128 |
Fax Number: | 8122310104 |
NPI Enumeration Date: | 05/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01032307B |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |