Organization
ST. JOSEPH VALLEY ANESTHESIA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRYL BEASLEY M.D. (PRESIDENT)
(574) 233-3123
Entity
Organization
Contact information
Practice address
5215 HOLY CROSS PARKWAY, MISHAWAKA, IN 46545-1469
(574) 335-5000
(574) 233-3125
Mailing address
PO BOX 1742, SOUTH BEND, IN 46634-1742
(574) 233-3123
(574) 233-3125
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200055220A
—
IN
Enumeration date
05/18/2006
Last updated
02/02/2010
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