MEDICARE: GREGORY BEARD

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	2086S0102X	Surgical Critical Care Physician	OS008021L	PA

General Provider Information

NPI Number	:	1821094996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY BEARD

Provider Business Mailing Address
First Line	:	300 STATE ST FL 4
Second Line	:	4TH FLOOR, SUITE 401
City	:	ERIE
State	:	PA
Zip	:	16507-1427
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 STATE ST FL 4
Second Line	:	4TH FLOOR, SUITE 401
City	:	ERIE
State	:	PA
Zip	:	16507-1427
Country	:	US
Telephone Number	:	814-877-4577
Fax Number	:

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	04/06/2021

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Directions to “ GREGORY BEARD ” Practice Location

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