Most Relevant Information
Provider Data
| NPI Number: | 1003066143 |
| Provider Name: | JOHN P BEAVERS NP |
| Entity Type: | Individual |
| Taxonomy Code: | 207P00000X |
| Specialty: | Emergency Medicine |
| License Number: | 4704234332 |
Most Important Dates
| Enumeration Date: | 09/25/2008 |
| Last Updated: | 10/13/2015 |
Provider Practice Location
5717 OAKLAND DR
PORTAGE
MI
490241116
Practice Location Phone/Fax
| Phone: | 2693234473 |
| Fax: |
Provider Mailing Location
5717 OAKLAND DR
PORTAGE
MI
490241116
Provider Mailing Phone/Fax
| Phone: | 2693234473 |
| Fax: | 5172782784 |