Provider Demographics
NPI:1720217789
Name:BEACH, ANDREW WILSON (PA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:WILSON
Last Name:BEACH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 VANDERBILT PARK DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1700
Mailing Address - Country:US
Mailing Address - Phone:828-274-6000
Mailing Address - Fax:828-277-6350
Practice Address - Street 1:5 VANDERBILT PARK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1700
Practice Address - Country:US
Practice Address - Phone:828-274-6000
Practice Address - Fax:828-277-6350
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00715363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant