Provider Demographics
NPI:1003070723
Name:BEARD, MARK R (DO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:R
Last Name:BEARD
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:28455 HAGGERTY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2982
Mailing Address - Country:US
Mailing Address - Phone:248-893-3213
Mailing Address - Fax:248-893-2951
Practice Address - Street 1:28455 HAGGERTY RD STE 200
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2982
Practice Address - Country:US
Practice Address - Phone:248-893-3200
Practice Address - Fax:248-893-2950
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2023-12-28
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Provider Licenses
StateLicense IDTaxonomies
MI5101017883204D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice