Individual ProviderBevin ClaytonEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address1105 6th St, Traverse City, MI 49684-2349(231) 947-0673PECOS EnrollmentBased on the most recent information from CMS, provider Bevin Clayton is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1013916071Provider TypeIndividualFull NameClayton, BevinCredentialDOGenderMaleSole ProprietorNoEnumeration Date7/20/2005Last Updated3/8/2016Contact InformationPractice LocationPractice Address1105 6th St, Traverse City, MI 49684-2349Phone(231) 947-0673Fax(801) 740-2847Mailing LocationMailing Address4624 N Spider Lake Rd, Traverse City, MI 49696-8440Phone(231) 947-0673Fax(801) 740-2847Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense5101009914MichiganProvider IdentifiersIDDescriptionIssuerID3446560DescriptionMedicaidIssuerUnlistedMichiganID010061693DescriptionOtherIssuerRAILROAD MEDICAREIDBC009914DescriptionOtherIssuerBLUE CROSS BLUE SHIELD