Provider Demographics
NPI:1548556368
Name:BECK, BRENDA SUE (DO)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:SUE
Last Name:BECK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BRENDA
Other - Middle Name:SUE
Other - Last Name:VOELKELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:810 W MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-1259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 W MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-1259
Practice Address - Country:US
Practice Address - Phone:440-415-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2017-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.010805207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology