MEDICARE: ALAN CLARK BEAN 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	2083X0100X	Occupational Medicine Physician	012730	ME

General Provider Information

NPI Number	:	1841411337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN CLARK BEAN M.D.

Provider Business Mailing Address
First Line	:	75 WESTON FARM ROAD
Second Line	:
City	:	HARRISON
State	:	ME
Zip	:	04040
Country	:	US
Telephone Number	:	207-583-2923
Fax Number	:	207-583-9008

Provider Business Practice Location Address
First Line	:	75 WESTON FARM ROAD
Second Line	:
City	:	HARRISON
State	:	ME
Zip	:	04040
Country	:	US
Telephone Number	:	207-583-4008
Fax Number	:	207-583-9008

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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