Provider Demographics
NPI:1023652088
Name:ARINE, BEDISHWAR WAYNE
Entity type:Individual
Prefix:
First Name:BEDISHWAR
Middle Name:WAYNE
Last Name:ARINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BEDISHWAR
Other - Middle Name:WAYNE
Other - Last Name:BRATHWAITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:419 N FEDERAL HWY APT 705
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3874
Mailing Address - Country:US
Mailing Address - Phone:202-294-6062
Mailing Address - Fax:
Practice Address - Street 1:1984 PEACHTREE RD NW STE 515
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-5219
Practice Address - Country:US
Practice Address - Phone:404-351-1745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-03
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA.367500000X, 367500000X
GARN234232367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered