DR. JACK MICHAEL BECKER M.D
Allergy and Immunology
Ardmore, Pennsylvania
Provider NPI: 1851349955
Provider Information:DR. JACK MICHAEL BECKER M.D
Practice Location:
233 E LANCASTER AVE SUITE 200 ARDMORE, PA 19003 US
Tel: 610-642-1643 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207K00000X | Physicians Allergy & Immunology | PA | MDO42717E |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| HIGHMARK PIN | 673732 | PA | 01 |
| 0012528080011 | PA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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