Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2008-01706 | NC |
N | 207QS0010X | Family Doctor - Sports Medicine | J7305 | TX |
NPI | 1003967910 |
---|---|
Provider Name | Dr. David Lowell Becker |
First Address | Charlotte, NC 28260-0447 |
Second Address | Matthews, NC 28105-2387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 25/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00894N | MEDICARE GROUP NUMBER (01) | TX |
BB4966240 | DEA NUMBER (01) | TX |
G36215 | (02) | TX |
J7305 | STATE LICENSE NUMBER (01) | TX |