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General NPI Number Information
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NPI Number | 1396032983
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Entity Type | Individual
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Provider Name | WALTER LEE BEARD JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2011
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 2124 CANDLER RD
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City | DECATUR
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State | GA
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Zip | 30032-5572
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Country | US
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Telephone | 404-836-0272
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Fax | 251-435-6357
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Provider Business Mailing Address
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Address Line | 2124 CANDLER RD
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City | DECATUR
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State | GA
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Zip | 30032-5572
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Country | US
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Telephone | 404-836-0272
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Fax | 251-435-6357
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 81780
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License Number State | GA
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