Individual
AMANDA RUTH BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
310 MEDICAL DR STE 102, CARMEL, IN 46032-3078
(317) 415-5960
Mailing address
310 MEDICAL DR STE 102, CARMEL, IN 46032-3078
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01069451A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11014385A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201022300
—
IN
Enumeration date
06/16/2008
Last updated
05/24/2022
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