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
Fax: (505) 325-6699
Website:

Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720185788 NPPES
Utah MEDICAID T0078
Utah MEDICAID 23325
Utah MEDICAID 225442
Utah MEDICAID 91082115

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