Organization
BEACON CANCER CARE PLLC
Active
Organization
BEACON CANCER CARE PLLC
Active
Other names
Beacon Clinic, Beacon Rheumatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CADWELL BARTELS DO (OWNER)
(208) 775-2804
Entity
Organization
Contact information
Practice address
3815 N SCHREIBER WAY STE 101, COEUR D ALENE, ID 83815-8362
(208) 755-2804
(208) 765-0277
Mailing address
3815 N SCHREIBER WAY STE 101, COEUR D ALENE, ID 83815-8362
(208) 755-2804
(208) 765-0277
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QX0200X
Oncology Clinic/Center
—
—
261QX0203X
Radiation Oncology Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407335367
—
ID
05
—
2107483
—
WA
Enumeration date
08/11/2018
Last updated
08/25/2023
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