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NPI Code Detail

MEDICARE: GREGORY MICHAEL BEDDELL M.D.

MEDICARE: GREGORY MICHAEL BEDDELL M.D.
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
12082S0099XPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician35088522OH
2208600000XSurgery Physician35.088522OH
32086S0102XSurgical Critical Care Physician35.088522OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14315911OTHEROHMEDICARE ID

Other Identifiers

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

General Provider Information

NPI Number : 1982825352
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY MICHAEL BEDDELL M.D.
Provider Business Mailing Address
First Line : 700 N COLUMBUS ST
Second Line :
City : CRESTLINE
State : OH
Zip : 44827-1455
Country : US
Telephone Number : 419-462-3485
Fax Number :
Provider Business Practice Location Address
First Line : 4275 STEELS POINTE
Second Line :
City : STOW
State : OH
Zip : 44224-6841
Country : US
Telephone Number : 330-923-0399
Fax Number : 330-923-6677
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 12/12/2025

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