MEDICARE: AYANNA BEARD MD

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	D65958	MD

General Provider Information

NPI Number	:	1184636714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYANNA BEARD MD

Provider Business Mailing Address
First Line	:	5100 AUTH WAY
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-4207
Country	:	US
Telephone Number	:	301-702-5100
Fax Number	:	301-702-5601

Provider Business Practice Location Address
First Line	:	5100 AUTH WAY
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-4207
Country	:	US
Telephone Number	:	301-702-5100
Fax Number	:	301-702-5601

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	10/26/2011

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