Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301072498 | MI |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 4301072498 | MI |
NPI | 1154313336 |
---|---|
Provider Name | Dr. Ryan A Beekman |
First Address | Detroit, MI 48267-0002 |
Second Address | Jackson, MI 49201-1852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 29/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2003810332 | BLUE CROSS BLUE SHIELD MI (01) | MI |
700C810580 | BCBSM GRP - ALLEGIANCE (01) | MI |
I11520 | (02) | MI |
P00421558 | RR MEDICARE (01) | MI |