Provider Demographics
NPI:1144424128
Name:DR GINA BEECH CHARTERED
Entity Type:Organization
Organization Name:DR GINA BEECH CHARTERED
Other - Org Name:BETHESDA BACK CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BEECH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-897-8500
Mailing Address - Street 1:9112 OLD GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1652
Mailing Address - Country:US
Mailing Address - Phone:301-897-8500
Mailing Address - Fax:301-897-9164
Practice Address - Street 1:9112 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1652
Practice Address - Country:US
Practice Address - Phone:301-897-8500
Practice Address - Fax:301-897-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO1244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMO95OtherCAREFIRST BCBS
DCS2460001OtherCAREFIRST BSBS
DCS2460001OtherCAREFIRST BSBS