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Individual

MS. BECQUIE BERCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
5 GARRETT AVE, LA PLATA, MD 20646-5960
(301) 609-4715
Mailing address
5 GARRETT AVE, LA PLATA, MD 20646-5960

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21082
CA

Other

Enumeration date
05/16/2012
Last updated
11/05/2018
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