Individual
BETH A BESAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 RALSTON AVE, SUITE 104, DEFIANCE, OH 43512-5311
(419) 783-6995
(419) 784-1606
Mailing address
1250 RALSTON AVE, SUITE 104, DEFIANCE, OH 43512-5311
(419) 783-6995
(419) 784-1603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35075892
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340015
ANTHEM
OH
01
—
03593
PHC
OH
01
—
2-95562
UHC
OH
05
—
2166507
—
OH
01
—
7656122
AETNA
OH
01
—
P00158158
RRMC
OH
Enumeration date
08/25/2005
Last updated
04/30/2012
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