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NPI Code Detail

MEDICARE: DR. ISLAM BEDAIWI MD

MEDICARE: DR. ISLAM BEDAIWI MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician04-46511KS

General Provider Information

NPI Number : 1710474085
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ISLAM BEDAIWI MD
Provider Business Mailing Address
First Line : 5600 S QUEBEC ST STE 312A
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-2208
Country : US
Telephone Number : 303-436-2727
Fax Number :
Provider Business Practice Location Address
First Line : 550 N HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-4976
Country : US
Telephone Number : 316-962-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2018
Last Update Date : 09/28/2022

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