Theodore Beatty, PA-C
Physician Assistant in Clinton Township, MI. Individual provider (NPI-1).
NPI number1306259262
StatusActive
Last updated in NPPESJun 9, 2014
Details
- NPI
- 1306259262
- Entity type
- Individual (NPI-1)
- Name
- Theodore Beatty
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 9, 2014
- Last updated
- Jun 9, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5601006977 | MI | Yes |
Practice location
15855 19 Mile RdClinton Township, MI 48038-3504
Phone 586-263-2300
Mailing address
266 Vester StFerndale, MI 48220-1714
Phone 810-614-9841
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All 55 Physician Assistant providers in Clinton Township · All 3,035 providers in Clinton Township
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