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General NPI Number Information
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NPI Number | 1770877672
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Entity Type | Individual
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Provider Name | ADAM T BEATTIE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2011
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Last Update Date | 11/13/2019
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Provider Practice Location Address
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Address Line | 3999 RICHMOND RD
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City | BEACHWOOD
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State | OH
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Zip | 44122-6046
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Country | US
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Telephone | 216-593-1495
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Fax | 216-201-5293
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Provider Business Mailing Address
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Address Line | 77 N AIRLITE ST
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City | ELGIN
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State | IL
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Zip | 60123-4912
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Country | US
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Telephone | 847-695-3200
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Fax | 847-931-5778
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 036134860
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 35.134365
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License Number State | OH
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