Basic Information
| Provider Information | |||||||||
| NPI: | 1740579911 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEVER | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | MERYL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9910 FRANKLIN SQUARE DR STE 2110 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212364902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109336423 | ||||||||
| FaxNumber: | 4109331390 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 ORLEANS ST RM 186 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109558893 | ||||||||
| FaxNumber: | 4103672194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2011 | ||||||||
| LastUpdateDate: | 05/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 258731 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RX0202X | D79318 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.