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Individual
BRUCE W BEAUCHAMP
Active
Individual
BRUCE W BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0.198
ID
207L00000X
Anesthesiology Physician
10096
ND
207L00000X
Anesthesiology Physician
1260
WA
207L00000X
Anesthesiology Physician
1499
WV
207L00000X
Anesthesiology Physician
Primary
16476
OR
207L00000X
Anesthesiology Physician
3891
AZ
207L00000X
Anesthesiology Physician
5697
AK
207L00000X
Anesthesiology Physician
DO 116462
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417978057
DEPT OF HUMAN SERVICES
MN
05
—
14198
—
ND
01
—
20-03471
MEDICA
ND
01
—
28761
ND BLUE CROSS BLUE SHIELD
ND
01
—
A06171050226
PREFERRED ONE
ND
Enumeration date
07/31/2006
Last updated
05/18/2010
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