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NPI Code Detail

MEDICARE: DR. CHARLES H BEYMER M.D.

MEDICARE: DR. CHARLES H BEYMER M.D.
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
1207RG0100XGastroenterology Physician29341WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ 0729680OTHERAZBLUE CROSS BLUE SHIELD OF
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194729608
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES H BEYMER M.D.
Provider Business Mailing Address
First Line : 1660 S COLUMBIAN WAY
Second Line : S-111-GASTRO VA PUGET SOUND HCS
City : SEATTLE
State : WA
Zip : 98108-1532
Country : US
Telephone Number : 206-277-4313
Fax Number : 206-764-2232
Provider Business Practice Location Address
First Line : 1660 S COLUMBIAN WAY
Second Line : S-111-GASTRO VA PUGET SOUND HCS
City : SEATTLE
State : WA
Zip : 98108-1532
Country : US
Telephone Number : 206-277-4313
Fax Number : 206-764-2232
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 05/01/2017

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