Basic Information
Provider Information
NPI: 1649304247
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DRONEN
FirstName: BEVERLY
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1137 N FREER RD
Address2:  
City: CHELSEA
State: MI
PostalCode: 481181149
CountryCode: US
TelephoneNumber: 7344751224
FaxNumber:  
Practice Location
Address1: 3960 PATIENT CARE WAY
Address2: SUITE 108
City: LANSING
State: MI
PostalCode: 489114275
CountryCode: US
TelephoneNumber: 5173948589
FaxNumber: 5173948594
Other Information
ProviderEnumerationDate: 03/15/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000X4301039883MIY Allopathic & Osteopathic PhysiciansGeneral Practice 

No ID Information.


Home