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General NPI Number Information
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NPI Number | 1245557487
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Entity Type | Individual
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Provider Name | MICHAEL BARRY BECKERMAN O.D.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2010
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Last Update Date | 04/28/2010
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Provider Practice Location Address
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Address Line | 6 WEAVERVILLE PLAZA
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City | WEAVERVILLE
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State | NC
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Zip | 28787
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Country | US
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Telephone | 828-658-2901
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Fax |
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Provider Business Mailing Address
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Address Line | 110 PINNACLE PEAK LN
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City | FLAT ROCK
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State | NC
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Zip | 28731-8559
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Country | US
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Telephone | 828-698-8083
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0852
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 503
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License Number State | SC
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