Provider Demographics
NPI:1659319051
Name:VAN BECELAERE, MARNIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARNIE
Middle Name:
Last Name:VAN BECELAERE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N MAIN ST
Mailing Address - Street 2:STE 300
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-3444
Mailing Address - Country:US
Mailing Address - Phone:316-282-9614
Mailing Address - Fax:316-284-9602
Practice Address - Street 1:301 N MAIN ST
Practice Address - Street 2:STE 300
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3444
Practice Address - Country:US
Practice Address - Phone:316-282-9614
Practice Address - Fax:316-284-9602
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0427176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine