MEDICARE: CHRISTOPHER K BEAMISH P.A.

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
1	363A00000X	Physician Assistant	MB0949377	MI

General Provider Information

NPI Number	:	1083722839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER K BEAMISH P.A.

Provider Business Mailing Address
First Line	:	1521 GULL RD
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-1640
Country	:	US
Telephone Number	:	269-226-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5943 STADIUM DR
Second Line	:	STE 3
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-3016
Country	:	US
Telephone Number	:	269-226-8315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	07/08/2007

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