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General NPI Number Information
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NPI Number | 1326034745
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Entity Type | Individual
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Provider Name | STEPHEN D BECK M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 1345 UNITY PL SUITE 110A
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City | LAFAYETTE
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State | IN
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Zip | 47905-5760
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Country | US
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Telephone | 765-447-9308
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Fax | 765-447-2387
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Provider Business Mailing Address
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Address Line | 1200 W WHITE RIVER BLVD RCS PE COORDINATOR
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City | MUNCIE
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State | IN
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Zip | 47303-4988
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Country | US
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Telephone | 765-751-5784
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036-133887
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 01046363A
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License Number State | IN
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