Individual
DR. MATTHEW A BECKERDITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2630 STATE HIGHWAY K, STE 100, OFALLON, MO 63368
(636) 240-5454
Mailing address
2630 STATE HIGHWAY K, STE 100, OFALLON, MO 63368
(636) 240-5454
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000161367
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080185383
RAILROAD MEDICARE
MO
05
—
1821062266
—
MO
Enumeration date
02/14/2006
Last updated
09/03/2021
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