Provider Demographics
NPI:1982370219
Name:BEIRNE, ELLEN (MB BCH BAO)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:
Last Name:BEIRNE
Suffix:
Gender:F
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MAYO CLINIC ARIZONA
Mailing Address - Street 2:4777 E MAYO BLVD
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-4502
Mailing Address - Country:US
Mailing Address - Phone:480-302-2000
Mailing Address - Fax:
Practice Address - Street 1:MAYO CLINIC ARIZONA
Practice Address - Street 2:5777 E MAYO BLVD
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-4502
Practice Address - Country:US
Practice Address - Phone:480-343-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR78894207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease