Healthcare Provider Details

I. General information

NPI: 1912186644
Provider Name (Legal Business Name): BECKER & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 WALKER AVE
BALTIMORE MD
21208-4023
US

IV. Provider business mailing address

15 WALKER AVE
BALTIMORE MD
21208-4023
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-6800
  • Fax: 410-484-6534
Mailing address:
  • Phone: 410-486-6800
  • Fax: 410-484-6534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberH31615
License Number StateMD

VIII. Authorized Official

Name: DR. ANDREW BECKER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 410-486-6800