MEDICARE: MEREDITH GRACE BECK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	292032	MA
2	208M00000X	Hospitalist Physician	292032	MA
3	207Q00000X	Family Medicine Physician	LL82571	SC

General Provider Information

NPI Number	:	1245897065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH GRACE BECK MD

Provider Business Mailing Address
First Line	:	BETH ISRAEL DEACONESS MEDICAL CENTER PLYMOUTH
Second Line	:	275 SANDWICH STREET
City	:	PLYMOUTH
State	:	MA
Zip	:	02360
Country	:	US
Telephone Number	:	508-830-2679
Fax Number	:	508-830-2702

Provider Business Practice Location Address
First Line	:	41 MALL RD
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01805-0001
Country	:	US
Telephone Number	:	781-744-8085
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	12/17/2025

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