MEDICARE: SUSAN L BECK DO

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	2086X0206X	Surgical Oncology Physician	DO-02091	IA

General Provider Information

NPI Number	:	1639284508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN L BECK DO

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-222-7474
Fax Number	:	515-222-7491

Provider Business Practice Location Address
First Line	:	1601 NW 114TH ST STE 151
Second Line	:
City	:	CLIVE
State	:	IA
Zip	:	50325-7046
Country	:	US
Telephone Number	:	515-222-7474
Fax Number	:	515-222-7491

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	03/05/2024

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