Provider Demographics
NPI:1841270915
Name:BEEBE, MEGAN MARIE (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:BEEBE
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 1:40 E HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-5011
Mailing Address - Country:US
Mailing Address - Phone:515-987-6610
Mailing Address - Fax:515-216-2910
Practice Address - Street 1:40 E HICKMAN RD
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-5011
Practice Address - Country:US
Practice Address - Phone:515-987-6610
Practice Address - Fax:515-216-2910
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36097208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1485300Medicaid
IAI17494Medicare PIN
IA1485300Medicaid