1467433524 NPI number — NOEL W BEDWELL M.D.

Table of content: NOEL W BEDWELL M.D. (NPI 1467433524)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467433524 NPI number — NOEL W BEDWELL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEDWELL
Provider First Name:
NOEL
Provider Middle Name:
W
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467433524
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 36258
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELFAST
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04915-1204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-243-4511
Provider Business Mailing Address Fax Number:
251-405-9900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6701 AIRPORT BLVD STE A107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36608-6774
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-435-8572
Provider Business Practice Location Address Fax Number:
251-435-8615
Provider Enumeration Date:
11/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  12166 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 15904 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0001X , with the licence number: 12166 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 529601560 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00115660 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1467433524 . This is a "INDIVIDUAL NPI NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 000033302 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1063477644 . This is a "GROUP NPI NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: G363 . This is a "GROUP MEDICARE NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: G364 . This is a "GROUP MEDICARE NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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