Provider Demographics
NPI:1164525341
Name:BEYEA, ANNETTE M (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:M
Last Name:BEYEA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5758
Mailing Address - Country:US
Mailing Address - Phone:207-626-7400
Mailing Address - Fax:207-626-7301
Practice Address - Street 1:6 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5758
Practice Address - Country:US
Practice Address - Phone:207-626-7400
Practice Address - Fax:207-626-7301
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHRT1451207R00000X
NH13846207R00000X
NC149380207RG0300X
NC2008-01409208M00000X
MEDO2514207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2022959Medicare PIN