Provider Demographics
NPI:1124020946
Name:BEH, WALTER P (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:P
Last Name:BEH
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 1:81 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-1781
Mailing Address - Country:US
Mailing Address - Phone:724-588-1444
Mailing Address - Fax:724-588-1445
Practice Address - Street 1:81 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-1781
Practice Address - Country:US
Practice Address - Phone:724-588-1444
Practice Address - Fax:724-588-1445
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033115L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0651414Medicaid
C30581Medicare UPIN
PA0651414Medicaid