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NPI Code Detail

MEDICARE: DR. ROY G BELVILLE MD

MEDICARE: DR. ROY G BELVILLE 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
1207P00000XEmergency Medicine PhysicianMD00043273WA

General Provider Information

NPI Number : 1881640076
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROY G BELVILLE MD
Provider Business Mailing Address
First Line : PO BOX 1668
Second Line :
City : SHELTON
State : WA
Zip : 98584-5001
Country : US
Telephone Number : 360-426-1611
Fax Number : 360-427-7335
Provider Business Practice Location Address
First Line : 901 MOUNTAIN VIEW DR
Second Line :
City : SHELTON
State : WA
Zip : 98584-4401
Country : US
Telephone Number : 360-427-9549
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 09/29/2009

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Directions to “ DR. ROY G BELVILLE MD” Practice Location

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