Individual
DR. MARSHALL D. BEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-5626
(706) 721-3813
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD60035970
WA
207LP2900X
Pain Medicine (Anesthesiology) Physician
83482
GA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
83482
GA
2084P0800X
Psychiatry Physician
Primary
83482
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001447
—
WA
05
—
8541336
—
WA
Enumeration date
10/14/2005
Last updated
08/07/2020
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