Healthcare Provider Details

I. General information

NPI: 1881855948
Provider Name (Legal Business Name): ANDREW RICHARD BEARDSLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2008
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 BREVARD RD
ASHEVILLE NC
28806-2316
US

IV. Provider business mailing address

PO BOX 117287
ATLANTA GA
30368-7287
US

V. Phone/Fax

Practice location:
  • Phone: 828-212-7021
  • Fax:
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number2018-02157
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2018-02157
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2018-02157
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: