Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 7561A | WY |
N | 207PE0004X | Emergency Medical Services | 5101014814 | MI |
NPI | 1023093622 |
---|---|
Provider Name | Bryan K Beck |
First Address | Littleton, CO 80120-5685 |
Second Address | Cheyenne, WY 82001-3748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 23/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4503760 | (05) | MI |
93058519 | (05) | CO |
F36228 | (02) |