Provider Demographics
NPI:1528069598
Name:BESHAI, EMAD FARID (MD)
Entity type:Individual
Prefix:DR
First Name:EMAD
Middle Name:FARID
Last Name:BESHAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S CLIFF AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1023
Mailing Address - Country:US
Mailing Address - Phone:605-322-5750
Mailing Address - Fax:605-322-5795
Practice Address - Street 1:1301 S CLIFF AVE STE 400
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1023
Practice Address - Country:US
Practice Address - Phone:605-322-5750
Practice Address - Fax:605-322-5795
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36497207R00000X
SD4212207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ187477Medicaid
SD6003195Medicaid
SDP00635415OtherRR MEDICARE
AZZ117057Medicare PIN
AZ187477Medicaid
SD6003195Medicaid
AZG38512Medicare UPIN