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General NPI Number Information
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NPI Number | 1245517382
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Entity Type | Individual
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Provider Name | TIMOTHY MUSE BEARDEN PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/03/2011
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | SCHWEINFURT ARMY HEALTH CLINIC CMR 457, BLDG 201
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City | APO AE
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State | NY
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Zip | 09033
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Country | US
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Telephone | 314-353-8349
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 464 BOX 2190
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City | APO
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State | AE
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Zip | 09226-0022
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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