Basic Information
Provider Information
NPI: 1164406310
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEALE
FirstName: SARAH
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10800 E GEDDES AVE STE 300
Address2:  
City: ENGLEWOOD
State: CO
PostalCode: 801123895
CountryCode: US
TelephoneNumber: 3037619190
FaxNumber: 7208744462
Practice Location
Address1: 10800 E GEDDES AVE STE 300
Address2:  
City: ENGLEWOOD
State: CO
PostalCode: 801123895
CountryCode: US
TelephoneNumber: 3037619190
FaxNumber: 7208744462
Other Information
ProviderEnumerationDate: 12/01/2005
LastUpdateDate: 02/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085N0700X30482CON Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085B0100X30482CON Allopathic & Osteopathic PhysiciansRadiologyBody Imaging
2085N0904X30482CON Allopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
2085P0229X30482PAN Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
2085R0202X30482COY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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