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Individual

DR. MAXINE RUTH BEATTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1212 LAKE JAMES DR, STE C, VIRGINIA BEACH, VA 23464
(757) 523-4589
(757) 523-8920
Mailing address
1212 LAKE JAMES DR, STE C, VIRGINIA BEACH, VA 23464
(757) 523-4589
(757) 523-8920

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101025142
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010107580
VA
Enumeration date
05/01/2006
Last updated
09/21/2012
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