Provider Demographics
NPI:1386902492
Name:BEVEL, WILLIAM DESMOND (RT (R))
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DESMOND
Last Name:BEVEL
Suffix:
Gender:M
Credentials:RT (R)
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Mailing Address - Street 1:1001 SOUTH MARSHALL STREET
Mailing Address - Street 2:SUITE 1-71 MAILBOX #2
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-5401
Mailing Address - Country:US
Mailing Address - Phone:336-602-3822
Mailing Address - Fax:800-665-3903
Practice Address - Street 1:1001 SOUTH MARSHALL STREET
Practice Address - Street 2:SUITE 1-71 MAILBOX #2
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-5401
Practice Address - Country:US
Practice Address - Phone:336-602-3822
Practice Address - Fax:800-665-3903
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLCRT 33615247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist