Healthcare Provider Details

I. General information

NPI: 1912975020
Provider Name (Legal Business Name): RICHARD JOESPH BEAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 33100 BOX LANDSTUHL
APO AE
09180-3100
US

IV. Provider business mailing address

UNIT 33100 BOX LANDSTUHL
APO AE
09180-3100
US

V. Phone/Fax

Practice location:
  • Phone: 937-846-5252
  • Fax:
Mailing address:
  • Phone: 314-590-8449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD-31746
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number30383
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-31746
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: