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NPI Code Detail

MEDICARE: DR. KERSTIN C BEACH MD

MEDICARE:  DR. KERSTIN C BEACH  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
1207Q00000XFamily Medicine Physician16235NE

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180119686OTHERNEMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
27348OTHERNEBCBS OF NEBRASKA
32054OTHERNEMIDLANDS CHOICE

General Provider Information

NPI Number : 1588670715
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KERSTIN C BEACH MD
Provider Business Mailing Address
First Line : 1579 MIDLAND ST
Second Line :
City : SYRACUSE
State : NE
Zip : 68446-9732
Country : US
Telephone Number : 402-269-2011
Fax Number : 402-269-2795
Provider Business Practice Location Address
First Line : 277 EAST 17TH STREET
Second Line :
City : SYRACUSE
State : NE
Zip : 68446
Country : US
Telephone Number : 402-269-2411
Fax Number : 402-269-3369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 09/25/2007

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Directions to “ DR. KERSTIN C BEACH MD” Practice Location

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