Beaumont, Gary Robert

Beaumont, Gary Robert is an individual health care provider with primary practice located at 3000 Saint Matthews Rd , Orangeburg SC 29118-1442. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Beaumont, Gary Robert can be contacted via phone (803) 395-2200.

Contact Information

Primary practice address
3000 Saint Matthews Rd Orangeburg SC 29118-1442
Fax:
Website:

Profile Details

NPI number 1376541722
LBN Legal business name Beaumont, Gary Robert
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Apr 27th, 2011 - about 13 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 1376541722 NPPES
Kentucky MEDICAID 74400805
Kentucky MEDICAID GP2825
Kentucky Other 4274202
Kentucky Other 000000685047

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