| NPI | 1891988036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH E BEATY Billing Agent 907-770-2380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-10-10 |