Provider Demographics
NPI:1295115160
Name:BEELER, MICHAEL BENJAMIN (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BENJAMIN
Last Name:BEELER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 482 BOX 2778
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362-0028
Mailing Address - Country:US
Mailing Address - Phone:315-646-7056
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL OKINAWA
Practice Address - Street 2:TARAWA RD. BUILDING #960
Practice Address - City:GINOWAN
Practice Address - State:OKINAWA
Practice Address - Zip Code:9012202
Practice Address - Country:JP
Practice Address - Phone:098-971-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-018482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology