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Individual
BETHANY ANN WARDLOW
Active
Individual
BETHANY ANN WARDLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45434
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518613
—
TN
Enumeration date
03/16/2007
Last updated
11/29/2012
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