Kavit Lache Beyersdorf, OD
Optometrist in Shawano, WI. Individual provider (NPI-1).
NPI number1447489661
StatusActive
Last updated in NPPESMay 11, 2022
Details
- NPI
- 1447489661
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kavit Lache Beyersdorf
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 9, 2009
- Certification date
- May 11, 2022
- Last updated
- May 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 3156-035 | WI | Yes |
Practice location
150a County Rd BShawano, WI 54166-7072
Phone 715-526-3163 · Fax 715-526-4019
Mailing address
Po Box 513Shawano, WI 54166-0513
Phone 715-526-3163 · Fax 715-526-4019
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