Provider Demographics
NPI:1699728311
Name:BEAVER, CATHLEEN RAMSEY (MD)
Entity type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:RAMSEY
Last Name:BEAVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 ETNA RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1455
Mailing Address - Country:US
Mailing Address - Phone:603-448-0055
Mailing Address - Fax:603-727-9042
Practice Address - Street 1:67 ETNA RD
Practice Address - Street 2:SUITE 350
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1455
Practice Address - Country:US
Practice Address - Phone:603-448-0055
Practice Address - Fax:603-727-9042
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH 10742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H20780Medicare UPIN
KS100215910MMedicaid
VT0RE5800Medicaid
NHRE580002Medicare PIN
KS033C893DMedicare PIN
NH30200894Medicaid
NHRE580001Medicare PIN