Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 04-32236 | KS |
N | 2080P0214X | Pediatric Pulmonologist | 04523R | LA |
Y | 2080P0214X | Pediatric Pulmonologist | 2006034478 | MO |
NPI | 1255398368 |
---|---|
Provider Name | Dr. Robert C Beckerman |
First Address | Pensacola, FL 32507-7488 |
Second Address | Pensacola, FL 32507-7488 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1195081 | (05) | LA |
1255398368 | (05) | LA |
B60331 | (02) |