Organization
SC MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVANIYA BEESLEY M.D. (MEMBER)
(702) 742-2036
Entity
Organization
Contact information
Practice address
10436 WINSLET DR, CHARLOTTE, NC 28277-2956
(702) 742-2036
Mailing address
10436 WINSLET DR, CHARLOTTE, NC 28277-2956
(702) 742-2036
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD40247
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SCA2449074
MEDICARE
SC
Enumeration date
07/25/2017
Last updated
07/21/2022
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