MEDICARE: SANDRA R. BEICHLER, D.O., INC.

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	208D00000X	General Practice Physician	34003309	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528210911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDRA R. BEICHLER, D.O., INC.

Provider Business Mailing Address
First Line	:	6310 MIDDLEBRANCH AVE NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-3555
Country	:	US
Telephone Number	:	330-493-8580
Fax Number	:	330-493-8540

Provider Business Practice Location Address
First Line	:	6310 MIDDLEBRANCH AVE NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-3555
Country	:	US
Telephone Number	:	330-493-8580
Fax Number	:	330-493-8540

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. SANDRA RUTH BEICHLER
Credential	:	D.O.
Telephone Number	:	330-493-8580

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	10/16/2008

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