Individual
CHARLES R. BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
395 W 27TH ST, LUMBERTON, NC 28358-3018
(910) 739-7551
(910) 738-3764
Mailing address
2002 N CEDAR ST STE B, LUMBERTON, NC 28358-3926
(910) 272-3048
(910) 738-3764
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28945
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14154
BCBS
NC
05
—
8928375
—
NC
Enumeration date
06/29/2005
Last updated
11/05/2020
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