Provider Demographics
NPI:1174573406
Name:BECKER, WARD G (MD)
Entity type:Individual
Prefix:
First Name:WARD
Middle Name:G
Last Name:BECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 W HAMILTON ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6459
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:67 IVY LEAGUE DR
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-9206
Practice Address - Country:US
Practice Address - Phone:610-683-5762
Practice Address - Fax:610-683-5219
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016864E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02539500OtherCAPITAL BLUE CROSS
PA103500OtherHIGHMARK BLUE SHIELD
PA0006393940003Medicaid
380001467OtherPALMETTO GBA
PA103500OtherHIGHMARK BLUE SHIELD
PAC30077Medicare UPIN