Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 3875 | WV |
Y | 1223E0200X | Endodontist | 7144 | SC |
N | 1223E0200X | Endodontist | 9190 | NC |
NPI | 1104054550 |
---|---|
Provider Name | Dr. Nathan Edward Beam |
First Address | Fort Mill, SC 29708-6562 |
Second Address | Fort Mill, SC 29708-6562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 22/01/2013 |