Provider Demographics
NPI:1285688002
Name:BEAM, WALTER D (DO)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:D
Last Name:BEAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3520 ROUTE 130 BLDG 1
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-1438
Mailing Address - Country:US
Mailing Address - Phone:724-744-3700
Mailing Address - Fax:724-744-3702
Practice Address - Street 1:3520 ROUTE 130 BLDG 1
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-1438
Practice Address - Country:US
Practice Address - Phone:724-744-3700
Practice Address - Fax:724-744-3702
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-004131L204D00000X
PAOS 004131L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM