Healthcare Provider Details

I. General information

NPI: 1134190549
Provider Name (Legal Business Name): ANN MARIE BECKMAN HALL MRE,RD,LD,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED ARMY MEDICAL CENTER WARD 48 NEPHROLOGY 9600 GEORGIA AVENUE NW
WASHINGTON DC
20307-0001
US

IV. Provider business mailing address

351 TSCHIFFELY SQUARE RD
GAITHERSBURG MD
20878-5628
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-6352
  • Fax: 202-782-0185
Mailing address:
  • Phone: 301-963-2132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License NumberDX 2469
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: