Provider Demographics
NPI:1023546454
Name:BEVAN, AARON (IDC)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:BEVAN
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 100285 BOX 1
Mailing Address - Street 2:
Mailing Address - City:MANAMA
Mailing Address - State:BAHRAIN
Mailing Address - Zip Code:09588-1904
Mailing Address - Country:BH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIT 100285 BOX 1
Practice Address - Street 2:
Practice Address - City:MANAMA
Practice Address - State:BAHRAIN
Practice Address - Zip Code:09588-1904
Practice Address - Country:BH
Practice Address - Phone:504-251-1935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman