Individual
MICHAEL EDGAR BEALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101025095
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1224139
AETNA HMO
—
01
—
188959
ANTHEM PROSPERITY
—
01
—
192391
ANTHEM FAIR OAKS
—
01
—
4091325
AETNA PPO
—
01
—
502646
NCPPS
—
01
—
N1900013
CAREFIRST BCBS
—
Enumeration date
08/16/2005
Last updated
02/21/2008
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