Dale William Beaumont, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301034186 Issued in MI

Practice address

42633 Garfield Rd Ste 318
Clinton Township, MI 48038-5033

Phone

(586) 286-7670

Fax

(586) 286-5179

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1164433108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42633 GARFIELD RD STE 318",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385033",
            "telephone_number": "586-286-7670",
            "fax_number": "586-286-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42633 GARFIELD RD STE 318",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385033",
            "telephone_number": "586-286-7670",
            "fax_number": "586-286-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUMONT",
        "first_name": "DALE",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301034186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1164433108",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY PROVIDER NUMBER FOR INDIVIDUAL NPI",
            "identifier": "0504232",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL PROVIDER TRANSACTION ACCESS NUMBER(PTAN)",
            "identifier": "P57770001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP PROVIDER TRANSACTION ACCESS NUMBER(PTAN)",
            "identifier": "0P57770",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2132199",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP NUMBER",
            "identifier": "1144495193",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linnea Bays, DPT
• Chelsea A Beal
• Bear With Me Behavior Solutions PLLC
• Katelyn Bearse, M.ED., BCBA, LBA
• Theodore Beatty, PA-C
• Beauty in Life Counseling LLC
• Michael Raphael Beauvais, PT
• Natalie Kathleen Beaver, BSW
• Austin Beba, DO
• Austine Beckley

• Gastroenterology Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.