MEDICARE: WILSON C. BEAMER 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
1	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	36290	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	050011295	OTHER	TN	UHC MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100010198	OTHER	TN	PHP TENNCARE
2	2002578	OTHER	TN	BLUE CROSS
3	2002578	OTHER	TN	BLUECARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821093170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILSON C. BEAMER M.D.

Provider Business Mailing Address
First Line	:	1027 ALTAMONT RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-6203
Country	:	US
Telephone Number	:	865-705-3526
Fax Number	:

Provider Business Practice Location Address
First Line	:	1027 ALTAMONT RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-6203
Country	:	US
Telephone Number	:	865-705-3526
Fax Number	:

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	06/05/2024

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