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:
Health care specialties
Specialty | Code | License # | 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 5 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 | 1558565838 | NPPES |
North Carolina | MEDICAID | 5915044 |
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