Provider Demographics
NPI:1851896468
Name:BEEMAN, MIRANDA DANIELL (DO)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:DANIELL
Last Name:BEEMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:DANIELL
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3344 CHAMBERS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-1403
Mailing Address - Country:US
Mailing Address - Phone:607-734-2264
Mailing Address - Fax:
Practice Address - Street 1:3344 CHAMBERS RD STE 100
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-1403
Practice Address - Country:US
Practice Address - Phone:607-734-2264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336509207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine