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General NPI Number Information
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NPI Number | 1316282288
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Entity Type | Individual
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Provider Name | ROBERT FREDRICK BEAUCHAMP MD
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Gender | Male
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Dates
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Enumeration Date | 12/04/2012
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 1 E WASHINGTON ST SUITE 17
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City | PHOENIX
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State | AZ
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Zip | 85004-2492
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Country | US
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Telephone | 602-255-8512
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Fax | 602-255-8716
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Provider Business Mailing Address
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Address Line | 1 E WASHINGTON ST SUITE 17
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City | PHOENIX
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State | AZ
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Zip | 85004-2492
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Country | US
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Telephone | 602-255-8512
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Fax | 602-255-8716
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 8520
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License Number State | AZ
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