Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1356PT | MD |
NPI | 1306832746 |
---|---|
Provider Name | Warren Gregory Belcher |
First Address | Salisbury, MD 21804-5259 |
Second Address | Salisbury, MD 21804-5259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 20/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
414562-02 | CAREFIRST BCBS IDENTIFIER (01) | MD |
8727-0001 | CAREFIRST GHMSI (01) | |
89NH-WG | CAREFIRST BCBS (01) | MD |
T77217 | (02) |