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General NPI Number Information
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NPI Number | 1043679699
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Entity Type | Individual
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Provider Name | CHAD WILLIAM BECKER D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 04/30/2020
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Provider Practice Location Address
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Address Line | 1200 PLEASANT ST
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City | DES MOINES
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State | IA
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Zip | 50309-1406
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Country | US
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Telephone | 515-241-6412
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Fax |
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Provider Business Mailing Address
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Address Line | 10497 NW 108TH PL
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City | GRANGER
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State | IA
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Zip | 50109-9797
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Country | US
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Telephone | 435-513-2004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO-05356
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 123456
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License Number State | CA
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