Beach, Michael J

Beach, Michael J is an individual health care provider with primary practice located at 7002 W Johnson Rd , La Porte IN 46350-8289. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Beach, Michael J can be contacted via phone (219) 325-0604.

Contact Information

Primary practice address
7002 W Johnson Rd La Porte IN 46350-8289
Phone: (219) 325-0604
Fax: (219) 879-1401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71000746A Indiana

Profile Details

NPI number 1942219878
LBN Legal business name Beach, Michael J
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2006
Last updated Feb 6th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942219878 NPPES
Indiana Other 000000792654 ANTHEM BCBS
Indiana MEDICAID 200233470 ANTHEM BCBS

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