Provider Demographics
NPI:1568431302
Name:BEARD, VALERIE A (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:BEARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:A
Other - Last Name:BEARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 775985
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5985
Mailing Address - Country:US
Mailing Address - Phone:317-770-6900
Mailing Address - Fax:317-770-6911
Practice Address - Street 1:17600 SHAMROCK BLVD STE 500B
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-7002
Practice Address - Country:US
Practice Address - Phone:317-867-5263
Practice Address - Fax:317-867-2031
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055468A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200427010AMedicaid
IN200427010AMedicaid
INP00017100Medicare PIN
IN441910Medicare PIN
IN1224690001Medicare NSC
IN177280015Medicare PIN
IN177280015Medicare PIN