Healthcare Provider Details

I. General information

NPI: 1033104831
Provider Name (Legal Business Name): NORMAN N BEIN M.D., FACS, RVT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2005
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CAMPTOWN RD
BREVARD NC
28712-3980
US

IV. Provider business mailing address

PO BOX 82
BREVARD NC
28712-0082
US

V. Phone/Fax

Practice location:
  • Phone: 314-323-5338
  • Fax:
Mailing address:
  • Phone: 636-346-8434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number2004025488
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number2004025488
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: