Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 49668 | MN |
NPI | 1013030691 |
---|---|
Provider Name | Daniel E Beistline |
First Address | Palmer, AK 99645-8891 |
Second Address | Palmer, AK 99645-8984 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 14/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
084948000 | (05) | MN |