Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 056091 | GA |
N | 208600000X | Surgeon | 056091 | GA |
N | 2086X0206X | Surgical Oncologist | 056091 | GA |
N | 2086X0206X | Surgical Oncologist | 53390 | AZ |
Y | 2086X0206X | Surgical Oncologist | MD-18903 | HI |
NPI | 1326015546 |
---|---|
Provider Name | Dr. Derrick J. Beech |
First Address | Atlanta, GA 30328-1934 |
Second Address | Wailuku, HI 96793-2416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 02/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003114446A | (05) | GA |
3839168 | (05) | TN |
F58725 | (02) | TN |