Provider Demographics
NPI:1154313336
Name:BEEKMAN, RYAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:A
Last Name:BEEKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RYAN
Other - Middle Name:A
Other - Last Name:BEEKMAN
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 67000
Mailing Address - Street 2:DEPARTMENT 272801
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-0002
Mailing Address - Country:US
Mailing Address - Phone:517-841-1431
Mailing Address - Fax:517-841-1432
Practice Address - Street 1:1201 E MICHIGAN AVE
Practice Address - Street 2:STE 300
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1852
Practice Address - Country:US
Practice Address - Phone:517-205-1431
Practice Address - Fax:517-205-1432
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072498174400000X, 207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700C810580OtherBCBSM GRP - ALLEGIANCE
MI2003810332OtherBLUE CROSS BLUE SHIELD MI
MIP00421558OtherRR MEDICARE
MII11520Medicare UPIN
MIM95720023Medicare PIN