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General NPI Number Information
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NPI Number | 1437491826
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Entity Type | Individual
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Provider Name | ROSS MATTHEW BECKMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2013
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 1001 JOHNSON FY RD NE
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City | ATLANTA
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State | GA
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Zip | 30342-1605
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Country | US
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Telephone | 845-417-3062
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Fax |
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Provider Business Mailing Address
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Address Line | 2917 BANKSHILL ROW NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-4552
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Country | US
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Telephone | 845-417-3062
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 97207
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License Number State | GA
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