1356733893 NPI number — NATALIE J. BEYELER, DO

Table of content: (NPI 1356733893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356733893 NPI number — NATALIE J. BEYELER, DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATALIE J. BEYELER, DO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356733893
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
410 MARKET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16365-1764
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-726-0211
Provider Business Mailing Address Fax Number:
814-723-1078

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
410 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16365-1764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-726-0211
Provider Business Practice Location Address Fax Number:
814-723-1078
Provider Enumeration Date:
02/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BEYELER
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
814-726-0211

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  OS016333 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1104885268 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1431924 . This is a "HEALTH AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 419946 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: MA1028205280001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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