Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD021180E | PA |
NPI | 1003919978 |
---|---|
Provider Name | Edward L Bellinger |
First Address | Wellsboro, PA 16901-1813 |
Second Address | Wellsboro, PA 16901-1813 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 19/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0008576330001 | (05) | PA |
070829 | BLUE SHIELD (01) | PA |
801909 | FIRST PRIORITY (01) | PA |
B34911 | (02) | PA |
P00798599 | RAILROAD MEDICARE (01) | PA |