Individual
DR. MATTHEW A BEACOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1625 E MILITARY AVE, FREMONT, NE 68025-5463
(402) 721-8830
(402) 721-8840
Mailing address
1625 E MILITARY AVE, FREMONT, NE 68025-5463
(402) 721-8830
(402) 721-8840
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21469
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07255
NE BCBS
NE
01
—
NA1756001
MEDICARE PTAN
NE
Enumeration date
07/27/2006
Last updated
10/24/2022
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