MEDICARE: DAVID D BEAL MD PC

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	207YX0901X	Otology & Neurotology Physician	798	AK

General Provider Information

NPI Number	:	1861674285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID D BEAL MD PC

Provider Business Mailing Address
First Line	:	PO BOX 241889
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99524-1889
Country	:	US
Telephone Number	:	907-563-1777
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 LAUREL ST
Second Line	:	STE 204
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5300
Country	:	US
Telephone Number	:	907-561-1426
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID D BEAL
Credential	:	MD
Telephone Number	:	907-561-1426

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	03/06/2008

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