Provider Demographics
NPI:1366569584
Name:BECK, JOEL B (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:B
Last Name:BECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11210 GOLF LINKS DR N, STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277
Mailing Address - Country:US
Mailing Address - Phone:704-800-4642
Mailing Address - Fax:704-800-4882
Practice Address - Street 1:11210 GOLF LINKS DR N, STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277
Practice Address - Country:US
Practice Address - Phone:704-800-4642
Practice Address - Fax:704-800-4882
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65079174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH13638Medicare UPIN