Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 12594 | NH |
N | 207W00000X | Ophthalmologist | 217143 | MA |
NPI | 1003818600 |
---|---|
Provider Name | Adam P Beck |
First Address | Andover, MA 01810-2605 |
Second Address | Londonderry, NH 03053-3564 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 27/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2014688 | (05) | MA |
30204108 | (05) | NH |
H89609 | (02) |