Provider Demographics
NPI:1114992252
Name:BEYER, DAVID C (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:BEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 E CAMELBACK RD STE 931
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4502
Mailing Address - Country:US
Mailing Address - Phone:602-753-5100
Mailing Address - Fax:602-483-1304
Practice Address - Street 1:3700 W STATE ROUTE 89A
Practice Address - Street 2:VERDE VALLEY MEDICAL CENTER - SEDONA
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4937
Practice Address - Country:US
Practice Address - Phone:928-204-4160
Practice Address - Fax:602-483-1304
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ121932085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ248197OtherAHCCCS
AZ248197OtherAHCCCS
AZZ30WCHJD07Medicare PIN