Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | D12269 | MN |
Y | 213EG0000X | General Practice | D12269 | MN |
NPI | 1003014184 |
---|---|
Provider Name | Adam Russell Beers |
First Address | Springfield, MN 56087-0009 |
Second Address | Springfield, MN 56087-4502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 05/12/2014 |