MEDICARE: ELIZABETH RENEE BEARD PT

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	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9335681	OTHER	WV	GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	001716788	OTHER	WV	BC/BS
4	001200	OTHER	WV	LICENSE

General Provider Information

NPI Number	:	1518951730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH RENEE BEARD PT

Provider Business Mailing Address
First Line	:	1509 FAIRMONT AVE
Second Line	:
City	:	FAIRMONT
State	:	WV
Zip	:	26554-2135
Country	:	US
Telephone Number	:	304-363-0050
Fax Number	:	304-363-0048

Provider Business Practice Location Address
First Line	:	200 FORT PIERPONT DR STE 107
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26508-1327
Country	:	US
Telephone Number	:	304-322-4232
Fax Number	:	43-224-2353

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

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	09/30/2020

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