BEAM, TERESA D (MD)

Provider Demographics

• NPI: 1972517720
• Name: BEAM, TERESA D (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: TERESA
• Middle Name: D
• Last Name: BEAM
• Gender: F
• Credentials: MD
• Mailing Address - Street 1: 679 E COUNTY LINE RD
• Mailing Address - City: GREENWOOD
• Mailing Address - State: IN
• Mailing Address - Zip Code: 46143-1049
• Mailing Address - Country: US
• Mailing Address - Phone: 317-807-1262
• Mailing Address - Fax: 317-859-4268
• Practice Address - Street 1: 14300 E 138TH STREET, BLDG A
• Practice Address - City: FISHERS
• Practice Address - State: IN
• Practice Address - Zip Code: 46037-0087
• Practice Address - Country: US
• Practice Address - Phone: 317-813-1660
• Practice Address - Fax: 317-813-1667
• Is Sole Proprietor?: No
• Enumeration Date: 2006-07-28
• Last Update Date: 2021-03-17

Provider Licenses

State	License ID	Taxonomies
IN	01046057A	208800000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	208800000X	Allopathic & Osteopathic Physicians	Urology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	200288740	Other	MEDICAID GROUP NUMBER
IN	340014541	Other	MEDICARE RAILROAD
IN	100194370	Other	MEDICAID GROUP NUMBER
IN	1669552295	Other	NOBLESVILLE DME NPI
IN	1487680518	Other	GROUP NPI
IN	000000091694	Other	ANTHEM PIN NUMBER
IN	340014542	Other	MEDICARE RAILROAD
IN	200123070	Medicaid
IN	340014540	Other	MEDICARE RAILROAD
IN	1205916830	Other	GREENWOOD DME NPI
IN	1487680518	Other	GROUP NPI
IN	597870O	Medicare PIN
IN	345000O	Medicare PIN
IN	1205916830	Other	GREENWOOD DME NPI
IN	340014540	Other	MEDICARE RAILROAD
IN	1669552295	Other	NOBLESVILLE DME NPI
IN	200288740	Other	MEDICAID GROUP NUMBER
IN	896480O	Medicare PIN