Healthcare Provider Details

I. General information

NPI: 1306944541
Provider Name (Legal Business Name): CHRISTOPHER BEVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 S EUTAW ST FRENKIL BLDG 3RD FL
BALTIMORE MD
21201-1606
US

IV. Provider business mailing address

16 S EUTAW ST FRENKIL BLDG 3RD FL
BALTIMORE MD
21201-1606
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-4323
  • Fax: 410-328-1149
Mailing address:
  • Phone: 410-328-4323
  • Fax: 410-328-1149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD35358
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: