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
Fax: (575) 680-2655
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164547709 NPPES
New Mexico MEDICAID 1164547709
New Mexico Other 1164547709

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