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Organization
BEAUREGARD MEDICAL CENTER, LTD
Active
Organization
BEAUREGARD MEDICAL CENTER, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN S PULIZZI JR. (PRESIDENT)
(703) 824-9397
Entity
Organization
Contact information
Practice address
3450 N BEAUREGARD ST, ALEXANDRIA, VA 22302-1200
(703) 820-7000
(703) 820-5564
Mailing address
3450 N BEAUREGARD ST, ALEXANDRIA, VA 22302-1200
(703) 820-7000
(703) 820-5564
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
NULL
207K00000X
Allergy & Immunology Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2156
CARE FIRST GROUP #
—
Enumeration date
03/19/2007
Last updated
11/19/2009
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