Individual
IGOR N BEDAREV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12230 ASHEVILLE HWY, INMAN, SC 29349-1845
(864) 472-2144
(864) 472-4696
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
90879
SC
207Q00000X
Family Medicine Physician
MD60323859
WA
208D00000X
General Practice Physician
MD60323859
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
908799
—
SC
01
—
SCS1625213
MEDICARE PIN
SC
Enumeration date
07/27/2010
Last updated
08/05/2024
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