Beale, Mark D
Beale, Mark D is an sole proprietor health care provider with primary practice located at 133 Wyatt Dr Suite 9, Las Cruces NM 88005-2962. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Beale, Mark D can be contacted via phone (575) 680-2684.Contact Information
Primary practice address
133 Wyatt Dr Suite 9
Las Cruces NM 88005-2962
Phone: (575) 680-2684
Fax: (575) 680-2655
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 2084P2900X | 93-208 | New Mexico |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 93-208 | New Mexico |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 93-208 | New Mexico |
Profile Details
| NPI number | 1164547709 |
|---|---|
| LBN Legal business name | Beale, Mark D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 20th, 2007 |
| Last updated | Feb 22nd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164547709 | NPPES |
| New Mexico | MEDICAID | 1164547709 | |
| New Mexico | Other | 1164547709 |
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