Healthcare Provider Details

I. General information

NPI: 1245938919
Provider Name (Legal Business Name): CHRISTOPHER WESLEY BEDFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9348 ALMAR PL
PITTSBURGH PA
15237-4872
US

IV. Provider business mailing address

9348 ALMAR PL
PITTSBURGH PA
15237-4872
US

V. Phone/Fax

Practice location:
  • Phone: 412-445-2329
  • Fax:
Mailing address:
  • Phone: 412-445-2329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP027139
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: