Individual
MR. WAYNE LEE BEAVER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 W STATE ST, SUITE 302, COLUMBUS, OH 43222-1536
(614) 221-2299
(614) 221-7458
Mailing address
777 W STATE ST, SUITE 302, COLUMBUS, OH 43222-1536
(614) 221-2299
(614) 221-7458
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35043307
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000216704
ANTHEM BCBS
OH
05
—
0429530
—
OH
Enumeration date
10/04/2005
Last updated
07/08/2007
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