Individual
MICHAEL LELAND BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1502 PEMBERTON DR UNIT D, SALISBURY, MD 21801
(410) 641-9450
(410) 641-9515
Mailing address
8678 SPUR LN, EASTON, MD 21601
(410) 641-9450
(410) 641-9515
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
H0057008
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
895000800
—
MD
Enumeration date
10/24/2005
Last updated
08/01/2025
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