Provider Demographics
NPI:1437440609
Name:WRIGHT BECKER, CAROL LEA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LEA
Last Name:WRIGHT BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:LEA
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2150 PENNSYLVANIA AVENUE, NW
Mailing Address - Street 2:THE GW MEDICAL FACULTY ASSOCIATES
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037
Mailing Address - Country:US
Mailing Address - Phone:202-741-2911
Mailing Address - Fax:202-741-2921
Practice Address - Street 1:2150 PENNSYLVANIA AVENUE, NW
Practice Address - Street 2:THE GW MEDICAL FACULTY ASSOCIATES
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-741-2911
Practice Address - Fax:202-741-2921
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WYTL3036207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program