Healthcare Provider Details

I. General information

NPI: 1013792209
Provider Name (Legal Business Name): AMEER ASHRAF BEDWAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 E SOUTH BLVD STE 308
MONTGOMERY AL
36116-2003
US

IV. Provider business mailing address

301 BROWN SPRINGS RD
MONTGOMERY AL
36117-7005
US

V. Phone/Fax

Practice location:
  • Phone: 334-747-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4493
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: