Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD17350 | OR |
NPI | 1053469569 |
---|---|
Provider Name | James Christopher Beard |
First Address | Portland, OR 97225-6699 |
Second Address | Portland, OR 97225-6699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 29/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
028055 | (05) | OR |
BB2769846 | DEA (01) | |
E93907 | (02) |