Provider Demographics
NPI:1437101292
Name:BECK, MARC RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:RICHARD
Last Name:BECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 E TUDOR RD
Mailing Address - Street 2:#164
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507
Mailing Address - Country:US
Mailing Address - Phone:907-382-0660
Mailing Address - Fax:866-305-3886
Practice Address - Street 1:4100 LAKE OTIS PKWY
Practice Address - Street 2:#102
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-382-0660
Practice Address - Fax:866-305-3886
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA366112085R0202X
MN493872085R0202X
AK65842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
133845OtherUCARE
IA0493106Medicaid
IA11087OtherWELLMARK BCBS
MN365460000Medicaid
1049255OtherPREFERRED ONE
AKMD0877Medicaid
IAI17665Medicare ID - Type Unspecified
IAP00335048Medicare ID - Type UnspecifiedRAILROAD MC
AKMD0877Medicaid