Individual
MR. STEPHEN V BECKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 SAINT JOHN ST STE 137, PORTLAND, ME 04102-3024
(207) 772-3800
(207) 774-3510
Mailing address
222 SAINT JOHN ST STE 137, PORTLAND, ME 04102-3024
(207) 772-3800
(207) 774-3510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2100
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025526
ANTHEM BCBS
—
05
—
23670000
—
ME
01
—
236700099
MAINE CARE
—
01
—
4414946
AETNA
—
01
—
M24238
CIGNA
—
01
—
M51022
CIGNA
—
01
—
MN2258
HARVARD PILGRIM
—
01
—
PT2100
LICENSE
—
Enumeration date
12/01/2005
Last updated
08/23/2010
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