1902913387 NPI number — CARLOS J BELMAR M.D.

Table of content: CARLOS J BELMAR M.D. (NPI 1902913387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902913387 NPI number — CARLOS J BELMAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELMAR
Provider First Name:
CARLOS
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902913387
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
221 S 6TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TERRE HAUTE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47807-4214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-242-3005
Provider Business Mailing Address Fax Number:
812-242-3054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1725 N 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TERRE HAUTE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47804-4010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-242-3005
Provider Business Practice Location Address Fax Number:
812-242-3054
Provider Enumeration Date:
08/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  01047399A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207X00000X , with the licence number: 36099107 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200149130 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200149130T , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 351904269180 . This is a "CARESOURCE MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 82816 . This is a "CIGNA PCP PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200149130W , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0182836 . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 339837 . This is a "HEALTHLINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00834673 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 351904269139 . This is a "CARESOURCE MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: N285392 . This is a "HARMONY HEALTH PLAN IND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000089594 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200149130O . This is a "MOLINA HEALTHCARE MCAID" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200149130Z , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com