Thomas Anthony-Martin Becker, P.T.A.
Individual provider Active NPI Contractor · Cedar Springs, MI
NPI 1780934869 · NPPES record last updated Sep 14, 2012
Key facts
- NPI
- 1780934869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 5502002747 (MI)
- Practice address
- 12704 Northland Dr
Cedar Springs, MI 49319-8452 - Phone
- (616) 292-4573
- NPI assigned
- Sep 14, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502002747 | MI | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 5502002747 | MI | Yes |
Addresses
Primary practice location
12704 Northland Dr
Cedar Springs, MI 49319-8452
Mailing address
12704 Northland Dr
Cedar Springs, MI 49319-8452
Other providers in Cedar Springs, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.