Individual
MARY K BECKWITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7120 CLEARVISTA DR, SUITE 4000, INDIANAPOLIS, IN 46256-1774
(317) 577-7444
(317) 577-7433
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01042099A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000647927
ANTHEM
IN
05
—
100442080
—
IN
01
—
P01014112
RR MEDICARE PTAN
IN
Enumeration date
11/16/2005
Last updated
11/27/2023
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