Provider Demographics
NPI:1710980412
Name:BEAMAN, ANTOINETTE ALONZO (MD)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:ALONZO
Last Name:BEAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANTOINETTE
Other - Middle Name:M
Other - Last Name:ALONZO-BEAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 NORTHPOINTE CIR
Mailing Address - Street 2:SUITE101
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-7851
Mailing Address - Country:US
Mailing Address - Phone:724-772-0777
Mailing Address - Fax:724-772-0050
Practice Address - Street 1:100 NORTHPOINTE CIR
Practice Address - Street 2:SUITE101
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7851
Practice Address - Country:US
Practice Address - Phone:724-772-0777
Practice Address - Fax:724-772-0050
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425932208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012714210002Medicaid
251781887OtherTIN