Provider Demographics
NPI:1073842902
Name:BEAL, SHEA M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHEA
Middle Name:M
Last Name:BEAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 JAMSILDONG SONGPAGU
Mailing Address - Street 2:GALLERIA PALACE A2608
Mailing Address - City:SEOUL
Mailing Address - State:SONGPAGU
Mailing Address - Zip Code:138 220
Mailing Address - Country:KR
Mailing Address - Phone:0102-056-4970
Mailing Address - Fax:
Practice Address - Street 1:121ST GENERAL HOSPITAL
Practice Address - Street 2:UNIT 15244
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-0017
Practice Address - Country:US
Practice Address - Phone:0118227-917-7984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00068559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist