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NPI Code Detail

MEDICARE: DR. ROBERT KENNETH BEAM MD, PHD

MEDICARE: DR. ROBERT KENNETH BEAM MD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2012-02000NC

General Provider Information

NPI Number : 1023084431
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT KENNETH BEAM MD, PHD
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6161 LAKE BRANDT RD UNIT B
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-8415
Country : US
Telephone Number : 336-643-5800
Fax Number : 336-643-7474
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2006
Last Update Date : 07/31/2024

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