Provider Demographics
NPI:1609861376
Name:MIKA, DAVID BEDRICK (MD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BEDRICK
Last Name:MIKA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:535 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1725
Mailing Address - Country:US
Mailing Address - Phone:434-978-2899
Mailing Address - Fax:434-973-0756
Practice Address - Street 1:535 WESTFIELD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1725
Practice Address - Country:US
Practice Address - Phone:434-978-2899
Practice Address - Fax:434-973-0756
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010353652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB06275Medicare UPIN