Provider Demographics
NPI:1891832846
Name:BEERBOWER, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:BEERBOWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10421 E COUNTY ROAD 100 N
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234-1243
Mailing Address - Country:US
Mailing Address - Phone:317-272-7013
Mailing Address - Fax:317-272-7007
Practice Address - Street 1:10421 E COUNTY ROAD 100 N
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46234-1243
Practice Address - Country:US
Practice Address - Phone:317-272-7013
Practice Address - Fax:317-272-7007
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN11013191A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200866710Medicaid
IN200866710Medicaid
IN200866710Medicaid