Provider Demographics
NPI:1215934666
Name:NIEHLS, BEVERLY J (MD)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:J
Last Name:NIEHLS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3970 PERKIOMEN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2719
Mailing Address - Country:US
Mailing Address - Phone:610-779-1330
Mailing Address - Fax:610-779-7699
Practice Address - Street 1:3970 PERKIOMEN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2719
Practice Address - Country:US
Practice Address - Phone:610-779-1330
Practice Address - Fax:610-779-7699
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2016-03-02
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Provider Licenses
StateLicense IDTaxonomies
PA032449E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012276090003Medicaid
PAE64032Medicare UPIN
PA0012276090003Medicaid