Individual
MR. NICHOLAS BEASTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.A.
Contact information
Practice address
6780 MAYFIELD ROAD, MAYFILED HEIGHTS, OH 44124-2212
(440) 312-4500
Mailing address
6780 MAYFIELD ROAD, MAYFILED HEIGHTS, OH 44124-2212
(440) 312-4500
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67.000167
OH
Other
Enumeration date
05/12/2010
Last updated
10/06/2010
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