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General NPI Number Information
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NPI Number | 1639253982
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Entity Type | Individual
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Provider Name | DAVID Q. BEVERSDORF M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 402 N KEENE ST
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City | COLUMBIA
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State | MO
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Zip | 65201-8369
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Country | US
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Telephone | 573-882-1515
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Fax | 573-884-0070
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Provider Business Mailing Address
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Address Line | PO BOX 843966
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City | KANSAS CITY
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State | MO
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Zip | 64184-3966
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Country | US
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Telephone | 573-884-3300
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Fax | 573-884-0943
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2008004262
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2008004262
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | 2008004262
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License Number State | MO
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