Healthcare Provider Details

I. General information

NPI: 1396702072
Provider Name (Legal Business Name): DAVID EARL BECK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 PAMPLICO HWY CAROLINA HOSPITAL SYSTEM
FLORENCE SC
29505-6019
US

IV. Provider business mailing address

2356 FREEDOM BLVD APT. B4
FLORENCE SC
29505-6089
US

V. Phone/Fax

Practice location:
  • Phone: 843-674-5000
  • Fax:
Mailing address:
  • Phone: 803-422-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number592
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: