MEDICARE: MR. PETER L BEYER RD

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	133V00000X	Registered Dietitian	7	KS

General Provider Information

NPI Number	:	1518292390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PETER L BEYER RD

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	DIETETICS AND NUTRITION KUMC 4013
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-2937
Country	:	US
Telephone Number	:	913-588-5358
Fax Number	:	913-588-8946

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	DIETETICS AND NUTRITION KUMC 4013
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-2937
Country	:	US
Telephone Number	:	913-588-5358
Fax Number	:	913-588-8946

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

Provider Enumeration Date	:	10/12/2009
Last Update Date	:	10/12/2009

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Directions to “ MR. PETER L BEYER RD” Practice Location

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