Provider Demographics
NPI:1790700375
Name:KAW, BEENU (MD)
Entity Type:Individual
Prefix:
First Name:BEENU
Middle Name:
Last Name:KAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 COOLIDGE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6361
Mailing Address - Country:US
Mailing Address - Phone:517-913-4050
Mailing Address - Fax:517-333-0893
Practice Address - Street 1:2601 COOLIDGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6361
Practice Address - Country:US
Practice Address - Phone:517-913-4050
Practice Address - Fax:517-333-0893
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301086776207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1032143OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI5208067Medicaid
MI1108267411OtherBLUE CROSS BLUE SHIELD/BLUE CARE NETWORK
MI0M54760005OtherMEDICARE PLUS BLUE
MIP00464733OtherRAILROAD MEDICARE
MI1032143OtherMCLAREN HEALTH ADVANTAGE
MI1032143OtherMCLAREN HEALTH PLAN-MEDICAID
MI200000014939OtherPHP
MI200000014939OtherPHP FAMILYCARE
MI7128940OtherAETNA
MI1108267411OtherBLUE CROSS BLUE SHIELD/BLUE CARE NETWORK
MI5208067Medicaid