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General NPI Number Information
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NPI Number | 1285835652
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Entity Type | Individual
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Provider Name | EDMOND A. BENDALY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 831 THEATRE DRIVE
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City | MARION
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State | IN
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Zip | 46952-1701
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Country | US
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Telephone | 765-660-7800
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Fax | 765-662-4470
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Provider Business Mailing Address
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Address Line | 330 NORTH WABASH SUITE G20
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City | MARION
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State | IN
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Zip | 46952-2600
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Country | US
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Telephone | 765-662-4133
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Fax | 765-651-7313
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | P51816
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License Number State | NY
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