Individual
STANLEY B BECKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
212 S SULLIVAN AVE, FREMONT, MI 49412-1548
(231) 924-1300
Mailing address
2537 MOMENTUM PL, CHICAGO, IL 60689-5325
(616) 975-1845
(616) 285-0846
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301052106
MI
207P00000X
Emergency Medicine Physician
Primary
4301052106
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301052106
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
930095239
RAILROAD MEDICARE
MI
Enumeration date
01/11/2007
Last updated
09/11/2012
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