Provider Demographics
NPI:1093773418
Name:BEEBE, CHRISTOPHER TODD (PA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TODD
Last Name:BEEBE
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4731 HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-5127
Mailing Address - Country:US
Mailing Address - Phone:843-839-7246
Mailing Address - Fax:843-839-7323
Practice Address - Street 1:4731 HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5090
Practice Address - Country:US
Practice Address - Phone:843-839-7246
Practice Address - Fax:843-839-7323
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCA00716363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC621077OtherSELECT HEALTH
SCP40836Medicare UPIN