Provider Demographics
NPI:1790954048
Name:BEVAN, KATHERINE A (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:A
Last Name:BEVAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:A
Other - Last Name:SCHUMACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:571-231-1324
Mailing Address - Fax:571-231-1324
Practice Address - Street 1:9300 DEWITT LOOP
Practice Address - Street 2:FBCH, EMERGENCY DEPARTMENT
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5285
Practice Address - Country:US
Practice Address - Phone:571-231-1324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102203870207PE0004X, 207PE0004X
LADO.000303207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services