1831141860 NPI number — NATALIE BELTRAN-KOEN M.D.

Table of content: NATALIE BELTRAN-KOEN M.D. (NPI 1831141860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831141860 NPI number — NATALIE BELTRAN-KOEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELTRAN-KOEN
Provider First Name:
NATALIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BELTRAN
Provider Other First Name:
NATALIE
Provider Other Middle Name:
CARMEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831141860
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
885 KEMPSVILLE RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23502-3800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-461-6342
Provider Business Mailing Address Fax Number:
757-963-6158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
885 KEMPSVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23502-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-461-6342
Provider Business Practice Location Address Fax Number:
757-963-6158
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  0101223612 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 006732097 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 468974 . This is a "MDIPA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 209072 . This is a "ANTHEM BCBS INSURANCE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 21887 . This is a "OPTIMA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541778786 . This is a "UNITED HEALTH CARE INS." identifier . This identifiers is of the category "OTHER".
  • Identifier: 5645135 . This is a "AETNA INSURANCE" identifier . This identifiers is of the category "OTHER".




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