Individual
DR. KIMBERLY LORRAINE BEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
520 N ELAM AVE, GREENSBORO, NC 27403-1127
(336) 547-1745
(336) 547-1827
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
01059021A
IN
207RG0100X
Gastroenterology Physician
37429
SC
207RG0100X
Gastroenterology Physician
Primary
9900013
NC
207RI0008X
Hepatology Physician
37429
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126KV
BCBS
NC
01
—
2011291
UNITED HEALTHCARE
NC
05
—
89126KV
—
NC
Enumeration date
10/20/2005
Last updated
02/16/2021
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