Provider Demographics
NPI:1558302695
Name:BEARD, DEBRA K (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:K
Last Name:BEARD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:535 S BURDICK ST
Mailing Address - Street 2:SUITE 256
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5294
Mailing Address - Country:US
Mailing Address - Phone:269-341-8822
Mailing Address - Fax:269-341-7518
Practice Address - Street 1:535 S BURDICK ST
Practice Address - Street 2:SUITE 256
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5294
Practice Address - Country:US
Practice Address - Phone:269-341-8822
Practice Address - Fax:269-341-7518
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2015-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIDB057402207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1760645386Medicaid
MI1902154958Medicaid
MI1417961137OtherBCBS - BRONSON
MI1558302695Medicaid
MI2738542Medicaid
MI1760645386Medicaid
MI1558302695Medicaid