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Individual

DR. JAMES WILLIAM BEAUCHAMP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
3261 OLD WASHINGTON RD, SUITE 2011, WALDORF, MD 20602-3223
(301) 396-9305
(301) 396-9309
Mailing address
9601 PULASKI PARK DR, SUITE 416, BALTIMORE, MD 21220-1409
(410) 933-5678

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01678
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10434460
CAQH ID NUMBER
01
1141701
ANOTHER AETNA #
01
1323843
AETNA
01
1551638
FIRST HEALTH INS
01
325540
PHCS INS. #
01
672779
ACN PROVIDER NUMBER
01
7365788
AETNA OTHER #'S
01
763B
MARYLAND BCBS
01
K4510001
BCBS FOR WASH DC
DC
01
K4510001
BCBS FEDERAL
01
S01678
CHIROPRACTIC LICENSE
MD
Enumeration date
11/09/2006
Last updated
06/02/2015
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