MEDICARE: MRS. HEATHER LYNN BECK PA-C

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	363AM0700X	Medical Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699881219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER LYNN BECK PA-C

Provider Business Mailing Address
First Line	:	10401 HOSPITAL DR STE 101
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-3150
Country	:	US
Telephone Number	:	301-856-2323
Fax Number	:	855-385-5335

Provider Business Practice Location Address
First Line	:	10401 HOSPITAL DR STE 101
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-3150
Country	:	US
Telephone Number	:	301-856-2323
Fax Number	:	855-385-5335

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	02/19/2018

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