Provider Demographics
NPI:1215362983
Name:BECKWITH, MARY SHELDON (PA-C MHS)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:SHELDON
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:PA-C MHS
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:SHELDON
Other - Last Name:BONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C MHS
Mailing Address - Street 1:5324 MCFARLAND DRIVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-401-7733
Mailing Address - Fax:919-401-7767
Practice Address - Street 1:5324 MCFARLAND DRIVE
Practice Address - Street 2:SUITE 410
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-401-7733
Practice Address - Fax:919-401-7767
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04447363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant