Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 5840 | SC |
NPI | 1104929355 |
---|---|
Provider Name | Dr. Robert Blanton Belk |
First Address | Anderson, SC 29622-2047 |
Second Address | Anderson, SC 29621-1580 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 12/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
058403 | (05) | SC |
C60279 | (02) | SC |