Provider Demographics
NPI:1366423907
Name:BECKWITH, ANDREW W (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:W
Last Name:BECKWITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 30
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230
Mailing Address - Country:US
Mailing Address - Phone:413-528-9311
Mailing Address - Fax:413-644-0274
Practice Address - Street 1:780 MAIN STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230
Practice Address - Country:US
Practice Address - Phone:413-528-1470
Practice Address - Fax:413-528-3167
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223952207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
043517461OtherCHAMPUS
043517461OtherHMC PPO
J2889OtherHMO BLUE
7731649OtherAETNA
10098934OtherCAPITAL DISTRICT PHP
MA2108968Medicaid
AA31086OtherHARVARD COMM HEALTH
3137730OtherCIGNA
4144072OtherMVP SELECT
MA110041473AMedicaid
80314OtherGIC INDEMNITY PLAN
I34223OtherMEDICARE UPIN
0035606OtherNEIGHBORHOOD HEALTH
000000030797OtherBMC HEALTH PLAN
36366OtherHEATH NEW ENGLAND
5619731OtherHCVM FIRST HEALTH
87582OtherHEALTHY START
J28789OtherBLUE SHIELD