MEDICARE: BEACHVIEW FAMILY HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	C20006548	DE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	491572	OTHER		HIGHMARK MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1326048	OTHER	DE	AETNA
2	75940001	OTHER	MD	CAREFIRST
3	8144955	OTHER	DE	UNITED HEALTHCARE
4	P00386934	OTHER		PALMETTO GBA

General Provider Information

NPI Number	:	1417286188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACHVIEW FAMILY HEALTH, LLC

Provider Business Mailing Address
First Line	:	550 ATLANTIC AVE
Second Line	:
City	:	MILLVILLE
State	:	DE
Zip	:	19967-6709
Country	:	US
Telephone Number	:	302-537-8318
Fax Number	:	302-539-8736

Provider Business Practice Location Address
First Line	:	550 ATLANTIC AVE
Second Line	:
City	:	MILLVILLE
State	:	DE
Zip	:	19967-6709
Country	:	US
Telephone Number	:	302-537-8318
Fax Number	:	302-539-8736

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	JULIE JOANNE HATTIER
Credential	:	D.O.
Telephone Number	:	302-537-8318

Provider Enumeration Date	:	12/09/2009
Last Update Date	:	12/09/2009

Similar Medicare Providers

1376632331 — JULIE JOANNE HATTIER D.O.
Practice Location Address:

550 ATLANTIC AVE
MILLVILLE, DE
19967-6709

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Practice Fax: 302-539-8736

1831493642 — MRS. ALLISON HEU SCRIVANI MS
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32630 CEDAR DR UNIT A
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1750364766 — DR. MELINDA ANN KOHR PH.D.
Practice Location Address:

32828 REBA RD STE A
MILLVILLE, DE
19967-6909

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1477525178 — DR. PETER JAMES LAMB PHD
Practice Location Address:

32828 REBA RD
MILLVILLE, DE
19967

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Practice Fax:

1528036142 — DR. RENE A PETERSON DPM
Practice Location Address:

35202 ATLANTIC AVE
MILLVILLE, DE
19967

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Directions to “BEACHVIEW FAMILY HEALTH, LLC ” Practice Location

Language	Start Address	Practice Location

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