Provider Demographics
NPI:1831344043
Name:MICHELLE L. BEUMER, PC
Entity type:Organization
Organization Name:MICHELLE L. BEUMER, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:BEUMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-390-9100
Mailing Address - Street 1:851 E 5TH ST.
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090
Mailing Address - Country:US
Mailing Address - Phone:636-390-9100
Mailing Address - Fax:636-390-9109
Practice Address - Street 1:851 E 5TH ST.
Practice Address - Street 2:SUITE 312
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090
Practice Address - Country:US
Practice Address - Phone:636-390-9100
Practice Address - Fax:636-390-9109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001023615208000000X
MO2002005319208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty