Healthcare Provider Details

I. General information

NPI: 1689315798
Provider Name (Legal Business Name): MARGARET DIANE BECKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET DIANE HOLDEMAN

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 N LINTEL DR
BLOOMINGTON IN
47404-8945
US

IV. Provider business mailing address

3050 N LINTEL DR
BLOOMINGTON IN
47404-8945
US

V. Phone/Fax

Practice location:
  • Phone: 317-385-6280
  • Fax:
Mailing address:
  • Phone: 317-385-6280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number01099758A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: