# DR. CHARLES T. BEAVERS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1235371691
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 04-45362 | KS | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 2014007653 | MO | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 73079 | TN | Yes |

## Other

- **Enumeration date:** 04/01/2009
- **Last updated:** 12/13/2024