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General NPI Number Information
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NPI Number | 1912091083
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Entity Type | Individual
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Provider Name | AMANDA A. BECK M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 7113 DEEPWATER POINT RD
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City | WILLIAMSBURG
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State | MI
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Zip | 49690-9249
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Country | US
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Telephone | 505-379-7333
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Fax | 505-379-7333
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Provider Business Mailing Address
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Address Line | 7113 DEEPWATER POINT RD
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City | WILLIAMSBURG
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State | MI
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Zip | 49690-9249
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Country | US
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Telephone | 505-379-7333
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Fax | 505-379-7333
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 82-162
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01075939A
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License Number State | IN
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