Provider Demographics
NPI:1730226432
Name:BEDINGHAUS, WANDA (MD)
Entity type:Individual
Prefix:DR
First Name:WANDA
Middle Name:
Last Name:BEDINGHAUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 S WADSWORTH BLVD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2108
Mailing Address - Country:US
Mailing Address - Phone:303-986-0492
Mailing Address - Fax:303-986-0486
Practice Address - Street 1:3900 S WADSWORTH BLVD STE 435
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2207
Practice Address - Country:US
Practice Address - Phone:303-986-0492
Practice Address - Fax:303-986-0486
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine