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Individual

DR. SAMUEL W BEENKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5510 HIGHWAY 280, SUITE 215, BIRMINGHAM, AL 35242-6582
(205) 624-4325
(205) 620-6776
Mailing address
176 BONNIEVILLE DR, CALERA, AL 35040-3606
(205) 478-7575
(855) 450-0848

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
15438
AL
208VP0000X
Pain Medicine Physician
Primary
PM.552
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000082627
BLUE CROSS
AL
05
000082627
AL
01
020016114
RAILROAD MEDICARE
AL
01
E50317
VIVA
AL
Enumeration date
06/16/2006
Last updated
01/29/2018
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