MEDICARE: DAVID BEGLY

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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1952022782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BEGLY

Provider Business Mailing Address
First Line	:	4503 HUDSON DR APT 3
Second Line	:
City	:	STOW
State	:	OH
Zip	:	44224-1734
Country	:	US
Telephone Number	:	330-802-4858
Fax Number	:

Provider Business Practice Location Address
First Line	:	4503 HUDSON DR APT 3
Second Line	:
City	:	STOW
State	:	OH
Zip	:	44224-1734
Country	:	US
Telephone Number	:	330-802-4858
Fax Number	:

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

Provider Enumeration Date	:	09/09/2022
Last Update Date	:	09/09/2022

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Directions to “ DAVID BEGLY ” Practice Location

Language	Start Address	Practice Location

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