Healthcare Provider Details

I. General information

NPI: 1417286188
Provider Name (Legal Business Name): BEACHVIEW FAMILY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2009
Last Update Date: 12/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 ATLANTIC AVE
MILLVILLE DE
19967-6709
US

IV. Provider business mailing address

550 ATLANTIC AVE
MILLVILLE DE
19967-6709
US

V. Phone/Fax

Practice location:
  • Phone: 302-537-8318
  • Fax: 302-539-8736
Mailing address:
  • Phone: 302-537-8318
  • Fax: 302-539-8736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC20006548
License Number StateDE

VIII. Authorized Official

Name: JULIE JOANNE HATTIER
Title or Position: OWNER/DOCTOR
Credential: D.O.
Phone: 302-537-8318