Individual
ROGER W BEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 B. NORTH VETERANS BOULEVARD, GLENNVILLE, GA 30427
(912) 654-4599
(912) 644-5260
Mailing address
460 MALL BLVD, SUITE B, SAVANNAH, GA 31406-4801
(912) 644-5300
(912) 644-3369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
028377
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000641946B
—
GA
05
—
000641946C
—
GA
01
—
08CBCPS
MEDICARE # CAHABA
GA
01
—
336806
WELLCARE
GA
Enumeration date
08/19/2006
Last updated
01/26/2017
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