Individual
DR. BRUCE EDMUND BEACHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1205 YORK RD, STE 20, LUTHERVILLE, MD 21093-6210
(410) 583-2328
(410) 583-2479
Mailing address
1205 YORK RD, STE 20, LUTHERVILLE, MD 21093-6210
(410) 583-2328
(410) 583-2479
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
D0019901
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010246
EHP
MD
01
—
134242486
CIGNA
MD
01
—
1720260110
GROUP NPI NUMBER
MD
01
—
3204645
AETNA
MD
01
—
37044
COVENTRY
MD
01
—
4067476
AETNA
MD
01
—
G847
CARE FIRST BLUE CHOICE
MD
01
—
KEI3BR
CARE FIRST BCBS
MD
01
—
P00012132
RAILROAD MEDICARE
MD
Enumeration date
11/10/2005
Last updated
09/09/2008
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