| Doctor Name: | DR. SAMUEL W BEENKEN |
| NPI Number: | 1801830815 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 15438 |
| Business Practice Address: | 5510 Highway 280 Suite 215 Birmingham, AL - 352426582 |
| Business Phone Number: | 2056244325 |
| Business Fax Number: | 2056206776 |
| Mailing Address: | 176 Bonnieville Dr, CALERA |
| State: | AL |
| Postal Code: | 350403606 |
| Phone Number: | 2054787575 |
| Fax Number: | 8554500848 |
| NPI Enumeration Date: | 06/16/2006 |
| NPI Last Update Date: | 05/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 15438 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |