Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD017637 | LA |
NPI | 1023081486 |
---|---|
Provider Name | David A Beary |
First Address | Marrero, LA 70072 |
Second Address | Marrero, LA 70072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1363065 | (05) | LA |
B63764 | (02) |