Provider Demographics
NPI:1174537856
Name:BEERS, CHARLES MICHAEL SR (PA)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:MICHAEL
Last Name:BEERS
Suffix:SR
Gender:M
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:PO BOX 585
Mailing Address - Street 2:112 EAST CLAY STREET
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-0585
Mailing Address - Country:US
Mailing Address - Phone:910-640-5012
Mailing Address - Fax:
Practice Address - Street 1:110 N BROWN ST
Practice Address - Street 2:
Practice Address - City:CHADBOURN
Practice Address - State:NC
Practice Address - Zip Code:28431-1716
Practice Address - Country:US
Practice Address - Phone:910-654-1701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101723363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant