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DR. ROLAND SPURGEON BEVERLY M.D.

MOHS-Micrographic Surgery >> Dermatology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1083687776

Individual Registrant:
DR. ROLAND SPURGEON BEVERLY M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
24541 PACIFIC PARK DR SUITE 103 ALISO VIEJO, CA 92656-3065 US
Tel: 949-831-3057  Fax: 949-831-2515

Contact information for business:
24541 PACIFIC PARK DR SUITE 103 ALISO VIEJO, CA 92656-3065 US
Tel: 949-831-3057  Fax: 949-831-2515

Registration Information:
NPI: 1083687776
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207ND0101XAllopathic & Osteopathic Physicians
Dermatology
MOHS-Micrographic Surgery
CAG65658
Y207N00000XAllopathic & Osteopathic Physicians
Dermatology
CAG65658

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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