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NPI Code Detail

MEDICARE: ROBERT ESTEP BEVERLY JR.

MEDICARE:   ROBERT ESTEP BEVERLY JR.
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
11710I1002XIndependent Duty Corpsman

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11710I1002XOTHERVAINDEPENDENT DUTY CORPSMAN

General Provider Information

NPI Number : 1972710168
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT ESTEP BEVERLY JR.
Provider Business Mailing Address
First Line : USS BARRY DDG 52
Second Line : MEDICAL DEPARTMENT
City : FPO
State : AE
Zip : 09565
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2016 ADOBE CT
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-4924
Country : US
Telephone Number : 757-227-3149
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 04/20/2008

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Directions to “ ROBERT ESTEP BEVERLY JR. ” Practice Location

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