Provider Demographics
NPI:1942229034
Name:BEEKMAN, STANLEY (DPM)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:BEEKMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133333 LORAIN AVENUE
Mailing Address - Street 2:13333 LORAIN AVENUE
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111
Mailing Address - Country:US
Mailing Address - Phone:216-941-3338
Mailing Address - Fax:216-941-7505
Practice Address - Street 1:13333 LORAIN AVE
Practice Address - Street 2:13333 LORAIN AVE
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3400
Practice Address - Country:US
Practice Address - Phone:216-941-3338
Practice Address - Fax:216-941-7505
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001802B213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0364921Medicaid
T80457Medicare UPIN
OHBE0446683Medicare ID - Type Unspecified