Individual
BEVIN CLAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1105 6TH ST, TRAVERSE CITY, MI 49684-2349
(231) 947-0673
(801) 740-2847
Mailing address
4624 N SPIDER LAKE RD, TRAVERSE CITY, MI 49696-8440
(231) 947-0673
(801) 740-2847
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101009914
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010061693
RAILROAD MEDICARE
—
05
—
3446560
—
MI
01
—
BC009914
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/20/2005
Last updated
03/08/2016
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