Basic Information
Provider Information
NPI: 1043213978
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEILES
FirstName: PAUL
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 804 SCOTT NIXON MEMORIAL DR
Address2:  
City: AUGUSTA
State: GA
PostalCode: 309072464
CountryCode: US
TelephoneNumber: 7066500705
FaxNumber: 7066501034
Practice Location
Address1: 24 STEVENS ST
Address2:  
City: NORWALK
State: CT
PostalCode: 068503852
CountryCode: US
TelephoneNumber: 2038522276
FaxNumber: 2038522527
Other Information
ProviderEnumerationDate: 05/24/2005
LastUpdateDate: 11/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X039141CTY Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X039141CTN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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