Provider Demographics
NPI:1639135122
Name:BEEVERS, STEVEN WALTER (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WALTER
Last Name:BEEVERS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 NORTHFIELD DR NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-7404
Mailing Address - Country:US
Mailing Address - Phone:319-378-8933
Mailing Address - Fax:
Practice Address - Street 1:3053 CENTER POINT RD NE
Practice Address - Street 2:SUITE B
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4049
Practice Address - Country:US
Practice Address - Phone:319-365-6973
Practice Address - Fax:319-365-6974
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00563213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0433086Medicaid
IA0433086Medicaid
IAU43104Medicare UPIN
IA44712Medicare PIN
IA71953Medicare PIN