Individual
DR. MICHAEL JOSEPH BEAUCLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1415 BLOSSOM PARK AVE, LAKEWOOD, OH 44107-4401
(216) 226-4694
Mailing address
1415 BLOSSOM PARK AVE, LAKEWOOD, OH 44107-4401
(216) 226-4694
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002647
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0814828
—
OH
Enumeration date
02/08/2007
Last updated
07/08/2007
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