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NPI Code Detail

MEDICARE: MICHAEL C BEAUDIS DPM

MEDICARE: MICHAEL C BEAUDIS DPM
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
1213E00000XPodiatrist36-00-3157OH
2213E00000XPodiatristSC-00-4647 RPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821095217
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL C BEAUDIS DPM
Provider Business Mailing Address
First Line : 63 PITT ST
Second Line :
City : SHARON
State : PA
Zip : 16146-2102
Country : US
Telephone Number : 724-658-4564
Fax Number : 724-657-8563
Provider Business Practice Location Address
First Line : 1112 S MILL ST
Second Line :
City : NEW CASTLE
State : PA
Zip : 16101-4629
Country : US
Telephone Number : 724-658-4564
Fax Number : 724-657-8563
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 10/10/2024

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Directions to “ MICHAEL C BEAUDIS DPM” Practice Location

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