Blake Donald Beauchamp, DO
Family Medicine in Burton, MI. Individual provider (NPI-1).
NPI number1740039239
StatusActive
Last updated in NPPESMay 16, 2024
Details
- NPI
- 1740039239
- Entity type
- Individual (NPI-1)
- Name
- Blake Donald Beauchamp
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 16, 2024
- Certification date
- May 16, 2024
- Last updated
- May 16, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 5151016798 | MI | Yes |
Practice location
1460 N Center RdBurton, MI 48509-1429
Phone 810-715-4300
Mailing address
1460 N Center RdBurton, MI 48509-1429
Phone 810-715-4300
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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