Provider Demographics
NPI:1306212089
Name:BECK, SHAUN D (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SHAUN
Middle Name:D
Last Name:BECK
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:8450 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1381
Mailing Address - Country:US
Mailing Address - Phone:317-802-2000
Mailing Address - Fax:317-802-2170
Practice Address - Street 1:1260 INNOVATION PKWY STE 100
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-3602
Practice Address - Country:US
Practice Address - Phone:317-884-5200
Practice Address - Fax:317-884-5360
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2022-10-05
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Provider Licenses
StateLicense IDTaxonomies
IN10001938A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant