Provider Demographics
NPI:1023182730
Name:BEEREL, ROY MARCEL (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:MARCEL
Last Name:BEEREL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 WASHINGTON PIKE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2862
Mailing Address - Country:US
Mailing Address - Phone:412-257-3395
Mailing Address - Fax:412-257-3379
Practice Address - Street 1:1370 WASHINGTON PIKE
Practice Address - Street 2:SUITE 206
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2862
Practice Address - Country:US
Practice Address - Phone:412-257-3395
Practice Address - Fax:412-257-3379
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050141L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01462019Medicaid
PA01462019Medicaid
PA038486Medicare ID - Type Unspecified