Individual
DR. MATTHEW C. BEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1919 LINCOLN WAY STE 315, COEUR D ALENE, ID 83814-2527
(208) 625-6000
(208) 625-6001
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5085
(208) 625-5731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M13757
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032402
—
AZ
01
—
R73512
TRAINING PERMIT
AZ
Enumeration date
06/25/2012
Last updated
04/15/2024
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