Provider Demographics
NPI:1487117297
Name:SIZER, BEAU (PHARM D)
Entity type:Individual
Prefix:MR
First Name:BEAU
Middle Name:
Last Name:SIZER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 20TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-4706
Mailing Address - Country:US
Mailing Address - Phone:701-320-4470
Mailing Address - Fax:
Practice Address - Street 1:706 38TH ST N STE A
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2953
Practice Address - Country:US
Practice Address - Phone:888-558-9941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH9073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist