Individual
DR. BRADLEY BEAMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 GROVE RD FL 1, GREENVILLE, SC 29605-4210
(864) 455-7899
(864) 455-5474
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2018-00690
NC
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
89495
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063890416
—
NC
01
—
19WGG
BCBS OF NC
NC
01
—
NN2300A
MEDICARE
NC
05
—
PENDING
—
SC
Enumeration date
05/18/2015
Last updated
07/03/2023
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