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Individual

DR. MICHAEL K BEDNARZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
120 N MEDICAL PKWY, BLDG 100, SUITE 102, WOODSTOCK, GA 30189-7062
(770) 926-4641
(770) 926-1692
Mailing address
1555 DOCTORS DR, STE. 106, LAGRANGE, GA 30240-4132
(706) 845-9370
(706) 845-9371

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001030
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1756326
LA
05
908119435A
GA
Enumeration date
10/24/2005
Last updated
03/13/2012
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