Individual
DR. MITCHELL DREW BEATUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120
(901) 767-3123
(901) 767-3884
Mailing address
P O BOX 1000 DEPT 0364, MEMPHIS, TN 38148-0364
(901) 767-3123
(901) 767-3884
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD26466
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121243
—
MS
01
—
110105498
RAILROAD MEDICARE
GA
05
—
139226001
—
AR
05
—
3090636
—
TN
Enumeration date
05/31/2006
Last updated
08/31/2011
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