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Individual

DR. MICHAEL ALAN BEASLEY

Active
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Individual

DR. MICHAEL ALAN BEASLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
MD483528
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104285805
—
PA
01
—
247169
MASSACHUSETTS LICENSE
MA
05
—
525196
—
AZ
01
—
900001779
EMPLOYEE NUMBER
AZ
Enumeration date
11/13/2009
Last updated
11/06/2024
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