Provider Demographics
NPI:1164512323
Name:BEALS, JOSEPH A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:BEALS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:390 PARK ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3400
Mailing Address - Country:US
Mailing Address - Phone:248-647-5660
Mailing Address - Fax:247-647-2664
Practice Address - Street 1:390 PARK ST
Practice Address - Street 2:SUITE 109
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3400
Practice Address - Country:US
Practice Address - Phone:248-647-5660
Practice Address - Fax:247-647-2664
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301043643207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP09510001Medicare ID - Type Unspecified
MIE26028Medicare UPIN