Healthcare Provider Details

I. General information

NPI: 1275277956
Provider Name (Legal Business Name): OLIVER MORGAN BEALE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 LOCUST STREET MERCY PAVILION
PITTSBURGH PA
15219
US

IV. Provider business mailing address

PO BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 412-642-5386
  • Fax:
Mailing address:
  • Phone: 214-645-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRA2025-0306
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberW6171
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: