Healthcare Provider Details

I. General information

NPI: 1578570545
Provider Name (Legal Business Name): ADAM BECK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ADAM W. BECK M.D.

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 06/30/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 19TH ST S
BIRMINGHAM AL
35249-1900
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-4011
  • Fax: 205-934-0024
Mailing address:
  • Phone: 205-731-9701
  • Fax: 205-297-9411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME104410
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number35356
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberL7660
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35356
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: