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General NPI Number Information
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NPI Number | 1609009166
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Entity Type | Organization
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Legal Business Name | BEALE BARIATRICS, LLC
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 1712 I ST NW SUITE 604
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City | WASHINGTON
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State | DC
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Zip | 20006-3702
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Country | US
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Telephone | 202-463-7872
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Fax | 202-478-0686
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Provider Business Mailing Address
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Address Line | 1712 I ST NW SUITE 604
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City | WASHINGTON
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State | DC
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Zip | 20006-3702
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Country | US
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Telephone | 202-463-7872
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Fax | 202-478-0686
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Authorized Official
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Title or Position | OWNER
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Name | MS. LISA M BEALE
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Credential |
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Telephone | 202-463-7872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number | MD25461
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License Number State | DC
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