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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