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NPI Code Detail

MEDICARE: SUSAN Y. BEATTY-PAGE P.A.C.

MEDICARE: SUSAN Y. BEATTY-PAGE P.A.C.
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
1363A00000XPhysician Assistant5601003207MI

General Provider Information

NPI Number : 1841220001
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN Y. BEATTY-PAGE P.A.C.
Provider Business Mailing Address
First Line : PO BOX 279
Second Line :
City : LINCOLN
State : MI
Zip : 48742-0279
Country : US
Telephone Number : 989-736-8157
Fax Number : 989-358-3763
Provider Business Practice Location Address
First Line : 11745 US HIGHWAY 23 S
Second Line :
City : OSSINEKE
State : MI
Zip : 49766-9582
Country : US
Telephone Number : 989-471-2156
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 03/08/2021

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Directions to “ SUSAN Y. BEATTY-PAGE P.A.C.” Practice Location

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