Healthcare Provider Details

I. General information

NPI: 1568074615
Provider Name (Legal Business Name): JAMES CHRISTOPHER BECK PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S HANOVER ST
BALTIMORE MD
21225-1233
US

IV. Provider business mailing address

3214 SIMPSON PARK RD
GAINESVILLE GA
30506-1432
US

V. Phone/Fax

Practice location:
  • Phone: 410-350-3200
  • Fax:
Mailing address:
  • Phone: 610-551-4084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0009010
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: