Provider Demographics
NPI:1194785402
Name:BEALE, ERNEST F (MD)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:F
Last Name:BEALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NEONATOLOGY SERVICES - ELLIOT HOSPITAL
Mailing Address - Street 2:ONE ELLIOT WAY
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103
Mailing Address - Country:US
Mailing Address - Phone:603-663-2692
Mailing Address - Fax:603-663-3982
Practice Address - Street 1:NEONATOLOGY SERVICES - ELLIOT HOSPITAL
Practice Address - Street 2:ONE ELLIOT WAY
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-663-2692
Practice Address - Fax:603-663-3982
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH84622080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0105776Y0NH02OtherANTHEM ACES #
NH008462OtherTUFTS
NH669768OtherCIGNA
NH20090YOtherANTHEM REFERRING RAN
NH206112OtherHPHC
NH3004695Medicaid
I04184Medicare UPIN
NH3004695Medicaid