Provider Demographics
NPI:1982684114
Name:BEALL, CAMMY L (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMMY
Middle Name:L
Last Name:BEALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8096 TWIN BEECH RD UNIT 150
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-7195
Mailing Address - Country:US
Mailing Address - Phone:251-278-6795
Mailing Address - Fax:
Practice Address - Street 1:8096 TWIN BEECH RD UNIT 150
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-7195
Practice Address - Country:US
Practice Address - Phone:251-278-6795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23219207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009995290Medicaid
AL009995290Medicaid
H01431Medicare UPIN