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General NPI Number Information
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NPI Number | 1568428605
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Entity Type | Individual
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Provider Name | RODOLFO SCOTT BEER MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 2016 VADALABENE DR
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City | MARYVILLE
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State | IL
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Zip | 62062-6901
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Country | US
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Telephone | 618-288-2970
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Fax |
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Provider Business Mailing Address
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Address Line | 9 KINGSLEY WAY
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City | GLEN CARBON
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State | IL
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Zip | 62034-1554
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Country | US
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Telephone | 618-288-2970
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 48244
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036140919
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License Number State | IL
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