Provider Demographics
NPI:1447464045
Name:BEECHER MEDICAL CLINIC INC
Entity type:Organization
Organization Name:BEECHER MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MANOHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ATRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-230-7200
Mailing Address - Street 1:1082 PROFESSIONAL DR
Mailing Address - Street 2:SUITE G1
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3635
Mailing Address - Country:US
Mailing Address - Phone:810-230-7200
Mailing Address - Fax:810-230-7202
Practice Address - Street 1:4855 BERL DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2801
Practice Address - Country:US
Practice Address - Phone:989-799-8000
Practice Address - Fax:989-799-8797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMA406605207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4219281OtherAETNA
MICIGNAOther1078667
MIGREATOther118391
MIBCOther1107309722
MIMCLAREN HEALTH PLANOther1001269
MIPRIORITY HEALTHOther31814
MI3127406Medicaid
MIP44780001Medicare PIN
MIGREATOther118391