MEDICARE: MICHAEL PETER BELLINO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	25MA05815700	NJ
2	207P00000X	Emergency Medicine Physician	1062722A	IN
3	207P00000X	Emergency Medicine Physician	036083583	IL
4	207P00000X	Emergency Medicine Physician	44817-020	WI
5	207P00000X	Emergency Medicine Physician	MD28630	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780670950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PETER BELLINO MD

Provider Business Mailing Address
First Line	:	7259 S BINGHAM JUNCTION BLVD
Second Line	:
City	:	MIDVALE
State	:	UT
Zip	:	84047-4860
Country	:	US
Telephone Number	:	801-930-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 FRANKLIN HEALTH CMNS
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6144
Country	:	US
Telephone Number	:	207-778-6031
Fax Number	:	207-779-2632

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	01/08/2025

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Directions to “ MICHAEL PETER BELLINO MD” Practice Location

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