Individual
DR. VIVIAN JOLLEY BEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA10160900
NJ
208600000X
Surgery Physician
Primary
300153-01
NY
208600000X
Surgery Physician
LL32911
SC
208600000X
Surgery Physician
Q9291
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366461701
—
TX
Enumeration date
07/01/2010
Last updated
02/13/2025
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