Provider Demographics
NPI:1245517382
Name:BEARDEN, TIMOTHY MUSE (PA-C)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:MUSE
Last Name:BEARDEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 464 BOX 2190
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09226-0022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SCHWEINFURT ARMY HEALTH CLINIC
Practice Address - Street 2:CMR 457, BLDG 201
Practice Address - City:APO AE
Practice Address - State:NY
Practice Address - Zip Code:09033
Practice Address - Country:US
Practice Address - Phone:314-353-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant