Provider Demographics
NPI:1588611149
Name:BESHAI, AMIR ZAHER (MD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:ZAHER
Last Name:BESHAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2373 G RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-9641
Mailing Address - Country:US
Mailing Address - Phone:970-243-3061
Mailing Address - Fax:970-245-8369
Practice Address - Street 1:2373 G RD
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-9641
Practice Address - Country:US
Practice Address - Phone:970-243-3061
Practice Address - Fax:970-245-8369
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32603174400000X
UT10352654-1205208800000X
CODR.0032603208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01326032Medicaid
CO01326032Medicaid
COCO5758Medicare UPIN
UT000057303Medicare ID - Type Unspecified