MEDICARE: MICHELLE L BEUMER

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	208000000X	Pediatrics Physician	2002005319	MO

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	:	1790781268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE L BEUMER

Provider Business Mailing Address
First Line	:	851 EAST FIFTH STREET
Second Line	:	STE 312
City	:	WASHINGTON
State	:	MO
Zip	:	63090
Country	:	US
Telephone Number	:	636-390-9100
Fax Number	:	636-390-9109

Provider Business Practice Location Address
First Line	:	851 E 5TH ST
Second Line	:	STE 312
City	:	WASHINGTON
State	:	MO
Zip	:	63090-3130
Country	:	US
Telephone Number	:	636-390-9100
Fax Number	:	636-390-9109

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	11/18/2008

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Directions to “ MICHELLE L BEUMER ” Practice Location

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