MEDICARE: MICHAEL D BECKER 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	207R00000X	Internal Medicine Physician	MD60556181	WA
2	207RC0000X	Cardiovascular Disease Physician	23554-020	WI
3	207UN0901X	Nuclear Cardiology Physician	23554-020	WI
4	207RC0000X	Cardiovascular Disease Physician	MD60556181	WA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811927726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D BECKER MD

Provider Business Mailing Address
First Line	:	4555 W SCHROEDER DR
Second Line	:	SUITE 170
City	:	MILWAUKEE
State	:	WI
Zip	:	53223-1475
Country	:	US
Telephone Number	:	414-365-3210
Fax Number	:	414-365-3225

Provider Business Practice Location Address
First Line	:	1233 N MAYFAIR RD
Second Line	:	SUITE 201
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-3255
Country	:	US
Telephone Number	:	414-774-6300
Fax Number	:

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/25/2019

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Directions to “ MICHAEL D BECKER MD” Practice Location

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