| NPI | 1114441227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BEATY Billing Agent 907-770-2301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AK 1055571) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2017-09-01 |