Individual
MICHAEL STEPHEN BEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
825 NICOLLET MALL STE 517, MINNEAPOLIS, MN 55402
(612) 788-8778
Mailing address
7770 DELL RD, STE 140, CHANHASSEN, MN 55317-9316
(952) 934-9360
(952) 975-0118
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
919
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629389341
—
MN
Enumeration date
06/28/2010
Last updated
02/15/2019
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