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Individual

STACEY BEAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3390 SAXONBURG BLVD, SUITE 250, GLENSHAW, PA 15116-3160
(412) 767-5967
(412) 767-5960
Mailing address
3390 SAXONBURG BLVD, SUITE 250, GLENSHAW, PA 15116-3160
(412) 767-5967
(412) 767-5960

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT023215
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225100000X
PA
Enumeration date
11/20/2013
Last updated
11/20/2013
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