Bruce E. Beacham, M.D., P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D0019901 Issued in MD

Legal business name

BRUCE E. BEACHAM, M.D., P.A.

Practice address

1205 York Rd
Suite 20
Lutherville, MD 21093-6210

Phone

(410) 583-2328

Fax

(410) 583-2479

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Carolyn Strain

Title

Office Manager

Phone

(410) 583-2328

Specialties & licenses 1

Addresses

Other identifiers 6

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1720260110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "SUITE 20",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-583-2328",
            "fax_number": "410-583-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "SUITE 20",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-583-2328",
            "fax_number": "410-583-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE E. BEACHAM, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "STRAIN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-583-2328",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0019901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EHP",
            "identifier": "010246",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE/FEDERAL BS",
            "identifier": "G847/0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3204645",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "KEI3/30272004",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "193582",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4067476",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.