Individual
BEVAN H LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 MINISTRY PKWY, WESTON, WI 54476-5220
(715) 393-1000
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
19198
HI
2085R0001X
Radiation Oncology Physician
Primary
6435320
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2010
Last updated
04/09/2026
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