Provider Demographics
NPI:1073581534
Name:BEATUS, REGINA ANN (MA, PT, CHT)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:ANN
Last Name:BEATUS
Suffix:
Gender:F
Credentials:MA, PT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 S DIVISION ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6921
Mailing Address - Country:US
Mailing Address - Phone:410-749-6760
Mailing Address - Fax:410-749-0492
Practice Address - Street 1:1344 S DIVISION ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6921
Practice Address - Country:US
Practice Address - Phone:410-749-6760
Practice Address - Fax:410-749-0492
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15397225100000X, 2251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR7570001OtherBLUE CHOICE
MDJO37OtherBCBS
MDJO37OtherBCBS
MD0995110001Medicare NSC