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General NPI Number Information
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NPI Number | 1912198664
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Entity Type | Individual
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Provider Name | DAVID O. BIDOT M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 3386 SHALLOWFORD RD NE
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City | CHAMBLEE
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State | GA
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Zip | 30341-3513
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Country | US
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Telephone | 787-525-6580
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80808
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City | ATLANTA
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State | GA
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Zip | 30366-0808
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Country | US
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Telephone | 787-525-6580
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 023566
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License Number State | GA
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