Individual
GWENDOLYN J. BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 S COLUMBIA RD, GRAND FORKS, ND 58201-4032
(701) 780-5000
Mailing address
1000 S COLUMBIA RD, GRAND FORKS, ND 58201-4032
(701) 780-5000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
18616
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040005280
PALMENTO GBA RR MEDICARE
NE
05
—
18616
—
NE
05
—
260997
—
NE
01
—
W308227
NORIDAN
WY
Enumeration date
07/27/2006
Last updated
04/02/2014
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