Provider Demographics
NPI:1548283831
Name:BEERMAN, PAUL J (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:BEERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1365 WESTGATE CENTER DR
Mailing Address - Street 2:SUITE K-1
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3106
Mailing Address - Country:US
Mailing Address - Phone:336-760-4450
Mailing Address - Fax:336-760-6197
Practice Address - Street 1:1365 WESTGATE CENTER DR
Practice Address - Street 2:SUITE K-1
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3106
Practice Address - Country:US
Practice Address - Phone:336-760-4450
Practice Address - Fax:336-760-6197
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC201012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010252997Medicaid
VA010253021Medicaid
VA010253039Medicaid
NC89131GAMedicaid
VA010253063Medicaid
VA010254451Medicaid
VA010252946Medicaid
VA010254361Medicaid
VA010253021Medicaid
NC89131GAMedicaid