Provider Demographics
NPI:1376980417
Name:BEATTY MEDICAL CONSULTING, PC
Entity Type:Organization
Organization Name:BEATTY MEDICAL CONSULTING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-453-1887
Mailing Address - Street 1:9507 BRANDEMERE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-1027
Mailing Address - Country:US
Mailing Address - Phone:704-453-1667
Mailing Address - Fax:
Practice Address - Street 1:9507 BRANDEMERE CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-1027
Practice Address - Country:US
Practice Address - Phone:704-453-1667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801162207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty