Beaver, Clint

Beaver, Clint is an individual health care provider with primary practice located at 106 Corporate Park Dr Suite 200 & 300, Mooresville NC 28117-7134. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Beaver, Clint can be contacted via phone (704) 235-9090.

Contact Information

Primary practice address
106 Corporate Park Dr Suite 200 & 300 Mooresville NC 28117-7134
Phone: (704) 235-9090
Fax: (704) 235-9101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 200901244 North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 200901244 North Carolina

Profile Details

NPI number 1558565838
LBN Legal business name Beaver, Clint
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2007
Last updated Oct 28th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558565838 NPPES
North Carolina MEDICAID 5915044

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