Beaver, Gary Wayne

Beaver, Gary Wayne is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Beaver, Gary Wayne can be contacted via phone (218) 786-8364.

Contact Information

Primary practice address
400 E 3Rd St Duluth MN 55805-1951
Phone: (218) 786-8364
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 43471 Minnesota

Profile Details

NPI number 1023051356
LBN Legal business name Beaver, Gary Wayne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Oct 26th, 2015 - about 11 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 1023051356 NPPES
Minnesota MEDICAID 589126400

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