Beaver, Bryan D

Beaver, Bryan D is an individual health care provider with primary practice located at 2304 Kossuth St , Lafayette IN 47904-3240. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Beaver, Bryan D can be contacted via phone (765) 446-9600.

Contact Information

Primary practice address
2304 Kossuth St Lafayette IN 47904-3240
Phone: (765) 446-9600
Fax: (765) 446-1100
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 01082967A Indiana
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X M1812 Guam

Profile Details

NPI number 1396833109
LBN Legal business name Beaver, Bryan D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Oct 15th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396833109 NPPES
Indiana MEDICAID 300031240
Indiana MEDICAID 208338905

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