Provider Demographics
NPI:1073572673
Name:BEAUMAN, CHERYL A (PA)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:BEAUMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:A
Other - Last Name:MEASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 CRESCENT COMMONS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8102
Mailing Address - Country:US
Mailing Address - Phone:919-851-5055
Mailing Address - Fax:919-851-3065
Practice Address - Street 1:115 CRESCENT COMMONS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8102
Practice Address - Country:US
Practice Address - Phone:919-851-5055
Practice Address - Fax:919-851-3065
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00835363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q15428Medicare UPIN