Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35982 | SC |
N | 111NI0900X | Internist | 35982 | SC |
N | 207RC0200X | Critical Care Medicine | 35982 | SC |
Y | 207RP1001X | Pulmonary Disease | 35982 | SC |
NPI | 1033107180 |
---|---|
Provider Name | Gregory L Becker |
First Address | North Myrtle Beach, SC 29582-0439 |
Second Address | Myrtle Beach, SC 29572-4114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
359828 | (05) | SC |