MEDICARE: MRS. BETH L HUMMER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	6558	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386604106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETH L HUMMER MD

Provider Business Mailing Address
First Line	:	PO BOX 20819
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89510-0819
Country	:	US
Telephone Number	:	775-689-9117
Fax Number	:	775-827-6715

Provider Business Practice Location Address
First Line	:	1535 MEDICAL PKWY STE A
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89703-4637
Country	:	US
Telephone Number	:	775-883-5505
Fax Number	:	775-883-6779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	07/21/2022

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