Individual
DR. DOUGLAS WAYNE BEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.S.H.A.
Contact information
Practice address
2412 FORUM BLVD, SUITE 201, COLUMBIA, MO 65203-6364
(573) 445-0725
(573) 445-1027
Mailing address
2412 FORUM BLVD, SUITE 201, COLUMBIA, MO 65203-6364
(573) 445-0725
(573) 445-1027
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD100429
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203349915
—
MO
Enumeration date
07/01/2005
Last updated
01/05/2014
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