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1417941337

NPI Code Detail

MEDICARE: MICHAEL C BECKETT MD

MEDICARE: MICHAEL C BECKETT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	46978	WI
2	208M00000X	Hospitalist Physician	46978	WI
3	207R00000X	Internal Medicine Physician	46978	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417941337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL C BECKETT MD

Provider Business Mailing Address
First Line	:	3 NEENAH CTR
Second Line	:
City	:	NEENAH
State	:	WI
Zip	:	54956-3070
Country	:	US
Telephone Number	:	920-729-2070
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 N GREEN BAY RD
Second Line	:
City	:	NEENAH
State	:	WI
Zip	:	54956-1954
Country	:	US
Telephone Number	:	920-729-2070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	06/16/2023

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Directions to “ MICHAEL C BECKETT MD” Practice Location

Language	Start Address	Practice Location

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