Provider Demographics
NPI:1104845742
Name:BEIL, RICHARD JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JACOB
Last Name:BEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5333 MCAULEY DR
Mailing Address - Street 2:SUITE R5001
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1014
Mailing Address - Country:US
Mailing Address - Phone:734-712-2323
Mailing Address - Fax:734-712-2312
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:SUITE R5001
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1014
Practice Address - Country:US
Practice Address - Phone:734-712-2323
Practice Address - Fax:734-712-2312
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060288208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF77737OtherHEALTH ALLIANCE PLAN
MI101200OtherCARE CHOICES HMO
MI2961OtherCAPE
MI3424320 10Medicaid
MIP84420OtherBLUE CARE NETWORK
MI3424320 10Medicaid
MI101200OtherCARE CHOICES HMO
MI2961OtherCAPE