Individual
SAMUEL RAYMOND BEISHLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-5724
(434) 924-9400
(434) 982-1618
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005880
VA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669570446
—
VA
Enumeration date
09/20/2006
Last updated
10/19/2020
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