Provider Demographics
NPI:1457685497
Name:MCBEIGH, CHADDWICK M (PA)
Entity Type:Individual
Prefix:
First Name:CHADDWICK
Middle Name:M
Last Name:MCBEIGH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:180 CHURCH HILL RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:ME
Mailing Address - Zip Code:04263-3418
Mailing Address - Country:US
Mailing Address - Phone:207-524-3501
Mailing Address - Fax:207-524-2093
Practice Address - Street 1:25 HOSPITAL DR STE A
Practice Address - Street 2:
Practice Address - City:BRIDGTON
Practice Address - State:ME
Practice Address - Zip Code:04009-1167
Practice Address - Country:US
Practice Address - Phone:207-647-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1746363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant