Individual
MARY MARGARET BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
(706) 236-6491
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
(706) 236-6491
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
056960
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
652877185A
—
GA
05
—
652877185B
—
GA
05
—
652877185C
—
GA
Enumeration date
05/19/2006
Last updated
03/23/2020
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