Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | DA031621 | PA |
N | 1223G0001X | General Practice | 30 - 021422 | OH |
N | 213EG0000X | General Practice | 30 - 021422 | OH |
N | 1223G0001X | General Practice | DS037360 | PA |
N | 213EG0000X | General Practice | DS037360 | PA |
NPI | 1265552491 |
---|---|
Provider Name | Dr. Mark Edward Beicke |
First Address | Pittsburgh, PA 15220-3510 |
Second Address | Pittsburgh, PA 15220-3510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 28/02/2021 |