Provider Demographics
NPI:1619975315
Name:BECK, ANNETTE M (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:BECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:205 W R D MIZE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2518
Mailing Address - Country:US
Mailing Address - Phone:816-228-4770
Mailing Address - Fax:816-228-1156
Practice Address - Street 1:11200 E WINNER RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-3964
Practice Address - Country:US
Practice Address - Phone:816-836-4300
Practice Address - Fax:816-836-2118
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO118199208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
031550OtherFAMILY HEALTH PARTNERS
5461776OtherAETNA
25902011OtherBLUE CROSS/BLUE SHIELD
1200339OtherUNITED HEALTH CARE
337290OtherFIRST GUARD
MO204632707Medicaid