Provider Demographics
NPI:1932190501
Name:BECHERT, DANIELLE B (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:B
Last Name:BECHERT
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 1:21279 N 83RD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6470
Mailing Address - Country:US
Mailing Address - Phone:260-438-8887
Mailing Address - Fax:260-438-8887
Practice Address - Street 1:5410 N SCOTTSDALE RD STE D100
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253
Practice Address - Country:US
Practice Address - Phone:602-892-4727
Practice Address - Fax:602-900-9997
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052309A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200347840Medicaid
000000021201OtherMPLAN
000000254634OtherBLUE CROSS BLUE SHIELD
IN080194364OtherRAILROAD MEDICARE
13480OtherPHYSICIANS HEALTH PLAN
IN925530IMedicare PIN
IN925510WMedicare PIN
IN925550EMedicare PIN
IN551730CMedicare PIN