1700078383 NPI number — CHERYL M BELLE MD P C

Table of content: (NPI 1700078383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700078383 NPI number — CHERYL M BELLE MD P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHERYL M BELLE MD P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1700078383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2809 NORTH AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23222-3647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-321-1400
Provider Business Mailing Address Fax Number:
804-329-8461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2809 NORTH AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23222-3647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-321-1400
Provider Business Practice Location Address Fax Number:
804-329-8461
Provider Enumeration Date:
08/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BELLE
Authorized Official First Name:
CHERLY
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
FAMILY PRACTICE PROVIDER
Authorized Official Telephone Number:
804-321-1400

Provider Taxonomy Codes

  • Taxonomy code: 207QA0505X , with the licence number:  0101049033 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: F79333 . This is a "UPIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0101049033 . This is a "STATE ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5640504 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 49D1042521 . This is a "CLIA" identifier . This identifiers is of the category "OTHER".




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