Individual
DR. GARY OWEN BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4414 LAKE BOONE TRAIL, SUITE 502, RALEIGH, NC 27607-7514
(919) 875-0539
(919) 875-1051
Mailing address
4414 LAKE BOONE TRAIL, SUITE 502, RALEIGH, NC 27607-7514
(919) 875-0539
(919) 875-1051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23998
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8914130
—
NC
Enumeration date
01/25/2006
Last updated
07/08/2007
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