MEDICARE: DR. JEFFREY M BEAL M.D.

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	207R00000X	Internal Medicine Physician	MA48763	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801891437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY M BEAL M.D.

Provider Business Mailing Address
First Line	:	108 S MAIN ST
Second Line	:	SUITE 6
City	:	OCEAN GROVE
State	:	NJ
Zip	:	07756-2016
Country	:	US
Telephone Number	:	732-776-8473
Fax Number	:	732-869-9160

Provider Business Practice Location Address
First Line	:	108 S MAIN ST
Second Line	:	SUITE 6
City	:	OCEAN GROVE
State	:	NJ
Zip	:	07756-2016
Country	:	US
Telephone Number	:	732-776-8473
Fax Number	:	732-869-9160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	11/22/2010

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