Individual
MICHAEL BEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1053 CENTER STREET, SC HOUSE CALL INC, WEST COLUMBIA, SC 29169
(800) 491-0909
Mailing address
1053 CENTER STREET, SC HOUSE CALL INC, WEST COLUMBIA, SC 29169
(800) 491-0909
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22780
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6238
—
SC
Enumeration date
06/25/2019
Last updated
02/13/2020
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