Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 5101009339 | MI |
NPI | 1013970383 |
---|---|
Provider Name | Dr. Kevin L. Beyer |
First Address | Kalamazoo, MI 49048-1650 |
Second Address | Kalamazoo, MI 49048-1650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2006 |
Last Update Date | 19/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053900234 | BCBSM (01) | MI |
2930933 | PHP (01) | MA |
3372583 | (05) | MA |
4334687 | AETNA (01) | MI |
A79566 | (02) | MA |
P77975G00646 | BCN (01) | MI |