MEDICARE: GREGORY J BECK M.D.

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	207RG0100X	Gastroenterology Physician	35052804	OH

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	:	1508831991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY J BECK M.D.

Provider Business Mailing Address
First Line	:	75 SYLVANIA DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45440-3237
Country	:	US
Telephone Number	:	937-320-5050
Fax Number	:	937-320-5060

Provider Business Practice Location Address
First Line	:	75 SYLVANIA DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45440-3237
Country	:	US
Telephone Number	:	937-320-5050
Fax Number	:	937-320-5060

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	10/14/2013

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