Individual
ANNE BEESON IVIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 SUSQUEHANNA VALLEY MALL DR STE A, SELINSGROVE, PA 17870-9148
(570) 374-7852
(570) 374-7932
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD474731
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035051270002
—
PA
01
—
1S4222
MEDICARE
PA
Enumeration date
06/22/2018
Last updated
04/15/2022
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