Individual
DWIGHT BEARDEN
Active
Individual
DWIGHT BEARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
028247
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260010573
RAIL ROAD MEDICARE #
GA
Enumeration date
11/16/2006
Last updated
11/30/2007
Update your record
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