MEDICARE: STEPHANIE A BEDARD PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	J1-0002114	DE
2	225100000X	Physical Therapist	18724	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00692856	OTHER	DE	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	AC44-0051	OTHER	DE	CAREFIRST
3	1154432268	OTHER	DE	DPCI
4	2519964	OTHER	DE	HIGHMARK
5	3763407000	OTHER	DE	IBC
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154432268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE A BEDARD PT

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	137 W HIGH ST
Second Line	:
City	:	ELKTON
State	:	MD
Zip	:	21921-8600
Country	:	US
Telephone Number	:	410-392-7027
Fax Number	:	410-392-5768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/22/2024

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Directions to “ STEPHANIE A BEDARD PT” Practice Location

Language	Start Address	Practice Location

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