Provider Demographics
NPI:1548461825
Name:DAVID D BEAL, MD
Entity type:Organization
Organization Name:DAVID D BEAL, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-561-1426
Mailing Address - Street 1:4001 LAUREL ST STE 204
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4001 LAUREL ST STE 204
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5332
Practice Address - Country:US
Practice Address - Phone:907-561-1426
Practice Address - Fax:907-561-7464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKD72088Medicare UPIN
AKK152729Medicare ID - Type Unspecified