Dr. John P Beavers
Nurse Practitioner Emergency Physician
5717 Oakland Dr
Portage
, Michigan 49024-1116
Dr. John P Beavers
Nurse Practitioner Emergency Physician
5717 Oakland Dr
Portage
, Michigan 49024-1116
(517) 278-2784
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About
Features
Specialties
- Emergency Physician
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Dr. John P Beavers
- 5717 Oakland Dr
- Portage, MI
- Zip : 49024-1116
- Fax : (517) 278-2784
- Phone : (269) 323-4473
Second Address
- Dr. John P Beavers
- 5717 Oakland Dr
- Portage, MI
- Zip : 49024-1116
- Phone : (269) 323-4473
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | 4704234332 | MI |
| Y | 363L00000X | Nurse Practitioner | 4704234332 | MI |
National Provider Identifier
| NPI | 1003066143 |
|---|---|
| Provider Name | Dr. John P Beavers |
| First Address | Portage, MI 49024-1116 |
| Second Address | Portage, MI 49024-1116 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/09/2008 |
| Last Update Date | 13/10/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1003066143 | (05) | MI |
| 500C961050 | BCBSM (01) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.