Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD 60443147 | WA |
Y | 207YS0123X | Facial Plastic Surgeon | MD-21894 | HI |
N | 207YS0123X | Facial Plastic Surgeon | MD60443147 | WA |
N | 207YS0123X | Facial Plastic Surgeon | R4944 | TX |
N | 208D00000X | General Practice Physician | 25871 | NE |
NPI | 1790911576 |
---|---|
Provider Name | Scott Eric Bevans |
First Address | Tripler Amc, HI 96859-5001 |
Second Address | Tripler Amc, HI 96859-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2009 |
Last Update Date | 20/09/2021 |