Provider Demographics
NPI:1174642888
Name:BEAUMONT, DAVID STRYKER (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STRYKER
Last Name:BEAUMONT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 WOODBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-4301
Mailing Address - Country:US
Mailing Address - Phone:215-752-1156
Mailing Address - Fax:
Practice Address - Street 1:457 WOODBOURNE RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-4301
Practice Address - Country:US
Practice Address - Phone:215-752-1156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001678L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000084711OtherHIGHMARK BS
PA0023255000OtherBC BS PERSONAL CHOICE
PAJ84711OtherAMERIHEALTH
PA0000084711OtherBC BS OF PA
PA0000084711OtherBC BS OF PA