Organization
PHYSICIAN'S WEIGHT MANAGEMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ELEANOR BEAL MD (OWNER)
(231) 935-8878
Entity
Organization
Contact information
Practice address
3537 W FRONT ST, SUITE H, TRAVERSE CITY, MI 49684-7941
(231) 935-8878
(231) 935-8901
Mailing address
3537 W FRONT ST, SUITE H, TRAVERSE CITY, MI 49684-7941
(231) 935-8878
(231) 935-8901
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102810071
BCBSM
MI
Enumeration date
02/20/2007
Last updated
08/22/2020
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