Provider Demographics
NPI:1962723148
Name:BEDDIS, BRENT CHARLES (DO)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:CHARLES
Last Name:BEDDIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8250 OLD YORK RD FL 2
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1514
Mailing Address - Country:US
Mailing Address - Phone:215-886-0440
Mailing Address - Fax:215-886-0447
Practice Address - Street 1:8250 OLD YORK RD FL 2
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1514
Practice Address - Country:US
Practice Address - Phone:215-886-0440
Practice Address - Fax:215-886-0447
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2018-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS016450207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine