Provider Demographics
NPI:1639261548
Name:BEALS, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:BEALS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7302 OSWEGO RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-3718
Mailing Address - Country:US
Mailing Address - Phone:315-461-9866
Mailing Address - Fax:315-461-0305
Practice Address - Street 1:7302 OSWEGO RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-3718
Practice Address - Country:US
Practice Address - Phone:315-461-9866
Practice Address - Fax:315-461-0305
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY131-471207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB81230Medicare UPIN