Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036136439 | IL |
N | 208600000X | Surgeon | 036136439 | IL |
Y | 2086S0129X | Vascular Surgeon | 036136439 | IL |
NPI | 1033384722 |
---|---|
Provider Name | Brian Robert Beeman |
First Address | Urbana, IL 61801-2529 |
Second Address | Urbana, IL 61801-2529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2008 |
Last Update Date | 27/10/2021 |