Provider Demographics
NPI:1578574646
Name:BEARD, MARY K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:K
Last Name:BEARD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:455 EAST SOUTH TEMPLE
Mailing Address - Street 2:#202
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84111
Mailing Address - Country:US
Mailing Address - Phone:801-355-9951
Mailing Address - Fax:801-355-9968
Practice Address - Street 1:455 EAST SOUTH TEMPLE
Practice Address - Street 2:#202
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84111
Practice Address - Country:US
Practice Address - Phone:801-355-9951
Practice Address - Fax:801-355-9968
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT1560531205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D07507Medicare UPIN