Individual
DR. BERT IRA BEVERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
258 MAIN ST, WATERVILLE, ME 04901-4857
(207) 873-2220
(207) 873-2221
Mailing address
258 MAIN ST, WATERVILLE, ME 04901-4857
(207) 873-2220
(207) 873-2221
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
012762
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134270000
—
ME
Enumeration date
12/29/2006
Last updated
07/09/2007
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