Provider Demographics
NPI:1700056728
Name:BEEREL MEDICAL LLC
Entity Type:Organization
Organization Name:BEEREL MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:MARCEL
Authorized Official - Last Name:BEEREL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-257-3395
Mailing Address - Street 1:1370 WASHINGTON PIKE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2862
Mailing Address - Country:US
Mailing Address - Phone:412-257-3395
Mailing Address - Fax:412-257-3379
Practice Address - Street 1:1370 WASHINGTON PIKE
Practice Address - Street 2:SUITE 206
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2862
Practice Address - Country:US
Practice Address - Phone:412-257-3395
Practice Address - Fax:412-257-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050141L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01462019Medicaid
PA038486Medicare PIN
PAF63376Medicare UPIN