Individual
BRANDON BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3941
Mailing address
823 WILDWOOD RD, WATERLOO, IA 50702-5517
(419) 297-1761
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34-08646
OH
207P00000X
Emergency Medicine Physician
Primary
3787
IA
Other
Enumeration date
07/09/2006
Last updated
07/08/2007
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