Provider Demographics
NPI:1093287559
Name:BEAMAN, CHRISTOPHER DUANE
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DUANE
Last Name:BEAMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3263 COLBY RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49461-8601
Mailing Address - Country:US
Mailing Address - Phone:231-893-0310
Mailing Address - Fax:
Practice Address - Street 1:3263 COLBY RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MI
Practice Address - Zip Code:49461-8601
Practice Address - Country:US
Practice Address - Phone:231-893-0310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist