Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1015 | ME |
N | 207P00000X | Emergency Physician | 1015 | ME |
NPI | 1184654568 |
---|---|
Provider Name | Bryan L Beck |
First Address | Scarborough, ME 04074-7609 |
Second Address | Harrison, ME 04040-4039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 03/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30223010 | (05) | NH |
329760099 | (05) | ME |
D93079 | (02) | ME |