Provider Demographics
NPI:1518289537
Name:BEY, AKIN (OWNER)
Entity Type:Individual
Prefix:
First Name:AKIN
Middle Name:
Last Name:BEY
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4932 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-7037
Mailing Address - Country:US
Mailing Address - Phone:919-696-4083
Mailing Address - Fax:
Practice Address - Street 1:4932 PEBBLE BEACH DR APT B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-7037
Practice Address - Country:US
Practice Address - Phone:919-696-4083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3837171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor