Healthcare Provider Details

I. General information

NPI: 1003028093
Provider Name (Legal Business Name): JULIE M BEARD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 A AVENUE
CEDAR RAPIDS IA
52402-3026
US

IV. Provider business mailing address

1026 A AVENUE SUITE 5000
CEDAR RAPIDS IA
52402-3026
US

V. Phone/Fax

Practice location:
  • Phone: 319-369-7105
  • Fax:
Mailing address:
  • Phone: 319-368-5976
  • Fax: 319-368-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License NumberAS27530459649
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number3988
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierP00740854
Identifier TypeOTHER
Identifier State
Identifier IssuerRR MEDICARE MEMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: