| NPI | 1568704229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH E BEATY Billing Agent 907-770-2380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AK 984995) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2016-12-30 |