Provider Demographics
NPI:1073559654
Name:BEUTEL, WILLIAM DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DEAN
Last Name:BEUTEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40908
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-0908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:910-862-2107
Practice Address - Street 1:300A E MCKAY ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-9037
Practice Address - Country:US
Practice Address - Phone:910-862-1272
Practice Address - Fax:910-862-2107
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30128208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7915414Medicaid
NC7915414Medicaid
NCA02498Medicare UPIN