Provider Demographics
NPI:1609009166
Name:BEALE BARIATRICS, LLC
Entity Type:Organization
Organization Name:BEALE BARIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-463-7872
Mailing Address - Street 1:1712 I ST NW
Mailing Address - Street 2:SUITE 604
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-3702
Mailing Address - Country:US
Mailing Address - Phone:202-463-7872
Mailing Address - Fax:202-478-0686
Practice Address - Street 1:1712 I ST NW
Practice Address - Street 2:SUITE 604
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3702
Practice Address - Country:US
Practice Address - Phone:202-463-7872
Practice Address - Fax:202-478-0686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD25461207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Single Specialty