Provider Demographics
NPI:1225138761
Name:BEDNO, SHERYL ANN (MD)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:BEDNO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 PINE LAWN PKWY
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-9166
Mailing Address - Country:US
Mailing Address - Phone:301-920-4586
Mailing Address - Fax:
Practice Address - Street 1:313 PINE LAWN PKWY
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-9166
Practice Address - Country:US
Practice Address - Phone:301-920-4586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI78021-202083P0901X, 2083X0100X
NJ25MA110345002083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100257554Medicaid