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NPI Code Detail

MEDICARE: SCOTT E. BEASECKER

MEDICARE: SCOTT E. BEASECKER
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
1207Q00000XFamily Medicine Physician4301051607MI

General Provider Information

NPI Number : 1841226131
Entity Type Code : Organization
Provider Name (Legal Business Name) : SCOTT E. BEASECKER
Provider Business Mailing Address
First Line : PO BOX 44047
Second Line :
City : DETROIT
State : MI
Zip : 48244-0047
Country : US
Telephone Number : 810-720-5715
Fax Number : 810-732-0891
Provider Business Practice Location Address
First Line : 506 N FRANKLIN ST
Second Line :
City : FRANKENMUTH
State : MI
Zip : 48734-1000
Country : US
Telephone Number : 989-652-9410
Fax Number : 989-652-9132
Authorized Official
Title or Position : OWNER
Name : SCOTT BEASECKER
Credential : M.D.
Telephone Number : 989-790-0007
Provider Enumeration Date : 06/25/2006
Last Update Date : 05/03/2010

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Directions to “SCOTT E. BEASECKER ” Practice Location

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