Provider Demographics
NPI:1437172236
Name:BECKER, DOUGLAS ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ALAN
Last Name:BECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:825 S 8TH ST
Mailing Address - Street 2:SUITE 550
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1208
Mailing Address - Country:US
Mailing Address - Phone:612-333-5000
Mailing Address - Fax:612-333-6922
Practice Address - Street 1:825 S 8TH ST
Practice Address - Street 2:SUITE 550
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-1208
Practice Address - Country:US
Practice Address - Phone:612-333-5000
Practice Address - Fax:612-333-6922
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN28103207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN394585500Medicaid
MNC00608Medicare Oscar/Certification
MN394585500Medicaid