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General NPI Number Information
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NPI Number | 1346390572
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Entity Type | Organization
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Legal Business Name | BEITMAN LASER EYE INSTITUTE PC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5813 W MAPLE RD #137
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-4400
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Country | US
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Telephone | 348-855-6200
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Fax | 248-855-7721
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Provider Business Mailing Address
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Address Line | 5813 W MAPLE RD #137
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-4400
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Country | US
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Telephone | 348-855-6200
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Fax | 248-855-7721
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT DAVID BEITMAN
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Credential | M.D.
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Telephone | 248-855-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | RB038148
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License Number State | MI
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