Provider Demographics
NPI:1992756761
Name:BECK, MATTHEW TODD (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:TODD
Last Name:BECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1313 KINGS CREST DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-5114
Mailing Address - Country:US
Mailing Address - Phone:540-375-3796
Mailing Address - Fax:
Practice Address - Street 1:CHARLES W. SCHIFFERT HEALTH CENTER, MCCOMAS HALL
Practice Address - Street 2:VIRGINIA TECH UNIVERSITY
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24061-0001
Practice Address - Country:US
Practice Address - Phone:540-231-6444
Practice Address - Fax:540-231-7473
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007967C51Medicare ID - Type UnspecifiedRCH EMERGENCY DEPT
F54805Medicare UPIN