Provider Demographics
NPI:1770752834
Name:BEECH, GEORGE DOUGLAS (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:DOUGLAS
Last Name:BEECH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 THOMAS JOHNSON DR STE 104
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4493
Mailing Address - Country:US
Mailing Address - Phone:301-951-9000
Mailing Address - Fax:240-831-5001
Practice Address - Street 1:178 THOMAS JOHNSON DR STE 104
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4493
Practice Address - Country:US
Practice Address - Phone:301-951-9000
Practice Address - Fax:240-831-5001
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-22
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD550177Medicare PIN