Doctor Name: | DR. RICHARD CHESTER BEARDEN |
NPI Number: | 1114350584 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 9381 |
Business Practice Address: | 200 Prison Rd Enoree, SC - 293352719 |
Business Phone Number: | 8038963523 |
Business Fax Number: | |
Mailing Address: | 5340 Reidville Rd, MOORE |
State: | SC |
Postal Code: | 293699749 |
Phone Number: | 8645742458 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2013 |
NPI Last Update Date: | 08/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 9381 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |