Provider Demographics
NPI:1295707982
Name:BEITER, AMY E (MD)
Entity type:Individual
Prefix:PROF
First Name:AMY
Middle Name:E
Last Name:BEITER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 E MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85256-5300
Mailing Address - Country:US
Mailing Address - Phone:480-362-3164
Mailing Address - Fax:
Practice Address - Street 1:10901 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85256-5300
Practice Address - Country:US
Practice Address - Phone:480-248-4678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20485208000000X
AZ20465207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ115114Medicaid
AZAZ0873670OtherBLUE CROSS BLUE SHIELD
AZ04-01930OtherEVERCARE
AZ115114-05Medicaid
AZF23037Medicare UPIN