Individual
DR. EDWARD BEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7500 CENTRAL AVE, SUITE 104, PHILADELPHIA, PA 19111-2430
(215) 742-0712
(215) 742-5218
Mailing address
7500 CENTRAL AVE, SUITE 104, PHILADELPHIA, PA 19111-2430
(215) 742-0712
(215) 742-5218
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD025011E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000642
AETNA
PA
01
—
0054706000
KEYSTONE
PA
01
—
100727800
TPI GROUP MEDICAID ID
PA
01
—
1047802
KEYSTONE MERCY
—
01
—
418283
BLUE SHIELD
—
01
—
597586
TPI GROUP MEDICARE PTAN
PA
01
—
CD4829
TPI GROUP RAILROAD MEDICARE
PA
Enumeration date
06/11/2006
Last updated
10/01/2012
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