Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 054463 | GA |
Y | 207X00000X | Orthopaedic Surgeon | ME81354 | FL |
NPI | 1023011905 |
---|---|
Provider Name | David A Bellamy |
First Address | Tallahassee, FL 32308-4470 |
Second Address | Tallahassee, FL 32308-4470 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 06/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000960583A | (05) | GA |
264250600 | (05) | FL |
H70884 | (02) | FL |