Provider Demographics
NPI:1598855892
Name:BEYER, GAIL SUZANNE (M D)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:SUZANNE
Last Name:BEYER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5500
Mailing Address - Country:US
Mailing Address - Phone:757-318-3700
Mailing Address - Fax:757-318-3701
Practice Address - Street 1:1020 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5500
Practice Address - Country:US
Practice Address - Phone:757-318-3700
Practice Address - Fax:757-318-3701
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056508207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5403531OtherAETNA
VA110217098OtherMEDICARE RAILROAD
VI433461OtherANTHEM BCBS OF VA
VA56575OtherOPTIMA
VI433461OtherANTHEM BCBS OF VA