IndividualActive
Michael Beasley, M.D.
NPI 1407183353 · Pediatric Sports Medicine Physician · Philadelphia, PA
Provider details
- NPI number
- 1407183353
- Entity type
- Individual
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- MD483528 (PA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (215) 590-1000
Fax: (267) 876-2181
Approximate (ZIP-level) locationGet directions
Mailing address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Registry dates
- Enumerated
- 2009-11-13
- Last updated
- 2024-11-06
- Certified
- 2024-11-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.