Bevan, Mark
Bevan, Mark is an individual health care provider with primary practice located at 812 W Maple St , Farmington NM 87401-5631. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Bevan, Mark can be contacted via phone (505) 326-6521.Contact Information
Primary practice address
812 W Maple St
Farmington NM 87401-5631
Phone: (505) 326-6521
Fax: (505) 325-6699
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 82-11 | New Mexico |
Profile Details
| NPI number | 1720185788 |
|---|---|
| LBN Legal business name | Bevan, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Mar 19th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720185788 | NPPES |
| Utah | MEDICAID | T0078 | |
| Utah | MEDICAID | 23325 | |
| Utah | MEDICAID | 225442 | |
| Utah | MEDICAID | 91082115 |
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