Provider Demographics
NPI:1487813416
Name:ROBERT G BEITMAN, MD PA
Entity type:Organization
Organization Name:ROBERT G BEITMAN, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:BEITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-465-2112
Mailing Address - Street 1:15 VILLAGE DR
Mailing Address - Street 2:P O BOX 70
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-1939
Mailing Address - Country:US
Mailing Address - Phone:609-465-2112
Mailing Address - Fax:609-463-0921
Practice Address - Street 1:15 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1939
Practice Address - Country:US
Practice Address - Phone:609-465-2112
Practice Address - Fax:609-463-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03712000207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4667506Medicaid
NJ442163179OtherRAILROAD MEDICARE
NJ4667506Medicaid
NJ127431Medicare PIN