Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 15501 | WV |
Y | 208600000X | Surgeon | 15501 | WV |
N | 2086S0102X | Surgical Critical Care | 15501 | WV |
N | 2086S0102X | Surgical Critical Care | 35969 | KY |
N | 2086S0120X | Pediatric Surgery | 15501 | WV |
N | 2086S0120X | Pediatric Surgery | 35969 | KY |
NPI | 1396701264 |
---|---|
Provider Name | Daniel Alfred Beals |
First Address | Huntington, WV 25701-3579 |
Second Address | Huntington, WV 25701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 01/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000000539899 | ANTHEM (01) | KY |
64011539 | (05) | KY |
G02417 | (02) |