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Individual

DR. MICHELLE RUTH BEAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Mailing address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS015069
PA
207L00000X
Anesthesiology Physician
OTO11729
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0239381
NJ
05
102498331
PA
Enumeration date
07/18/2007
Last updated
02/24/2014
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