Healthcare Provider Details

I. General information

NPI: 1811192412
Provider Name (Legal Business Name): AMY MARIE BECKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY MARIE FARACE MD

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
BALTIMORE MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5255
  • Fax: 301-760-3382
Mailing address:
  • Phone: 410-933-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number14896
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number2014-01254
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberD0093540
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: