MEDICARE: MARK ALLEN BECHTEL D.O.

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	207Q00000X	Family Medicine Physician	TL996	SC
2	207Q00000X	Family Medicine Physician	2006-00859	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00349261	OTHER	SC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962493361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ALLEN BECHTEL D.O.

Provider Business Mailing Address
First Line	:	PO BOX 531797
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-1797
Country	:	US
Telephone Number	:	704-834-2450
Fax Number	:	704-671-5331

Provider Business Practice Location Address
First Line	:	1680 RIBAUT RD
Second Line	:
City	:	PORT ROYAL
State	:	SC
Zip	:	29935-2008
Country	:	US
Telephone Number	:	843-524-3344
Fax Number	:	844-295-9894

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	03/23/2021

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Directions to “ MARK ALLEN BECHTEL D.O.” Practice Location

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