Individual
DR. JOHN E.W. BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12255 FAIR LAKES PARKWAY, FAIRFAX, VA 22033
(703) 934-5905
(703) 934-5778
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0101046190
VA
207RP1001X
Pulmonary Disease Physician
Primary
D0054803
MD
Other
Enumeration date
12/29/2006
Last updated
11/14/2011
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