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General NPI Number Information
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NPI Number | 1558630053
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Entity Type | Organization
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Legal Business Name | BEV FINGERHOOD, LTD
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 2127 BLUESTONE DR SUITE 203
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City | SAINT CHARLES
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State | MO
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Zip | 63303-6709
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Country | US
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Telephone | 636-916-5575
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Fax | 636-916-0387
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Provider Business Mailing Address
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Address Line | 2127 BLUESTONE DR SUITE 203
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City | SAINT CHARLES
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State | MO
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Zip | 63303-6709
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Country | US
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Telephone | 636-916-5575
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Fax | 636-916-0387
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Authorized Official
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Title or Position | CORPORATION PRESIDENT
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Name | DR. BEV FINGERHOOD
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Credential |
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Telephone | 636-916-5575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD100875
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License Number State | MO
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