Individual
CHARLES JEFFREY BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
140 KIMEL PARK DR, WINSTON-SALEM, NC 27103-6946
(336) 245-2100
(336) 765-6135
Mailing address
2000 FRONTIS PLAZA BLVD STE 200, ATTN FORSYTH MEDICAL GROUP, WINSTON SALEM, NC 27103-5616
(336) 277-2436
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
100198
NC
Other
Enumeration date
04/03/2006
Last updated
08/29/2007
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