Provider Demographics
NPI:1659431336
Name:BEACH, MARGARET (PA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BEACH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 79088
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2800 S SHIRLINGTON RD
Practice Address - Street 2:STE 102
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206
Practice Address - Country:US
Practice Address - Phone:703-738-4336
Practice Address - Fax:703-998-8256
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001000652363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant