Provider Demographics
NPI:1164481966
Name:BEYER, ERIK A (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:A
Last Name:BEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 NW 49TH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7266
Mailing Address - Country:US
Mailing Address - Phone:954-739-2273
Mailing Address - Fax:954-739-2742
Practice Address - Street 1:3001 NW 49TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7266
Practice Address - Country:US
Practice Address - Phone:954-739-2273
Practice Address - Fax:954-739-2742
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000045514208G00000X
TXJ8459208G00000X
FLME114363208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015647300Medicaid
TX168351803Medicaid
TXP00184709OtherRR/MEDICARE
TX1683518-01OtherCSHCN
TX8AP707OtherBLUE CROSS BLUE SHIELD
TN1629016399OtherORGANIZATION NPI
TX1683518-01Medicaid
TX8M7991OtherBLUE SHIELD
FLIG176ZMedicare PIN
TX8M7991OtherBLUE SHIELD
TX8K4664Medicare PIN
TX8AP707OtherBLUE CROSS BLUE SHIELD
TXG42151Medicare UPIN
FLIG176YMedicare PIN