MEDICARE: THOMAS E. 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	41806	MN

General Provider Information

NPI Number	:	1902869266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS E. BECKER MD

Provider Business Mailing Address
First Line	:	940 POLO CLUB RD
Second Line	:
City	:	INDEPENDENCE
State	:	MN
Zip	:	55359-9233
Country	:	US
Telephone Number	:	612-598-8628
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 POLO CLUB RD
Second Line	:
City	:	INDEPENDENCE
State	:	MN
Zip	:	55359-9233
Country	:	US
Telephone Number	:	612-598-8628
Fax Number	:

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

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	12/31/2018

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Directions to “ THOMAS E. BECKER MD” Practice Location

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