Provider Demographics
NPI:1043220510
Name:BEIM, GLORIA M (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:M
Last Name:BEIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GLORIA
Other - Middle Name:MARIANNE
Other - Last Name:BEIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2472 PATTERSON RD UNIT 8
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1100
Mailing Address - Country:US
Mailing Address - Phone:970-241-0202
Mailing Address - Fax:
Practice Address - Street 1:112 W SPENCER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2545
Practice Address - Country:US
Practice Address - Phone:970-641-6788
Practice Address - Fax:970-641-0282
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34655174400000X
CODR.0034655207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01346550Medicaid
CO841522905OtherEIN
CO01346550Medicaid
COC477568Medicare PIN