MEDICARE: WOODLAND HEALTH CARE SERVICES PC

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	207P00000X	Emergency Medicine Physician	MB047056	MI

General Provider Information

NPI Number	:	1578501292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLAND HEALTH CARE SERVICES PC

Provider Business Mailing Address
First Line	:	611 COURT ST
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-9390
Country	:	US
Telephone Number	:	989-345-7000
Fax Number	:	989-345-7479

Provider Business Practice Location Address
First Line	:	611 COURT ST
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-9390
Country	:	US
Telephone Number	:	989-345-7000
Fax Number	:	989-345-7479

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL WARREN BEASLEY
Credential	:	M.D.
Telephone Number	:	989-345-7000

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	03/26/2009

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