Provider Demographics
NPI:1053379487
Name:BECKER, ANDREW MOSS (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MOSS
Last Name:BECKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 744786
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-4786
Mailing Address - Country:US
Mailing Address - Phone:704-834-2450
Mailing Address - Fax:704-671-5331
Practice Address - Street 1:815 COX RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3453
Practice Address - Country:US
Practice Address - Phone:704-865-1700
Practice Address - Fax:704-865-7948
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010469232084N0400X
DCMD0441232084N0400X
NC2024-024432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE93555Medicare UPIN