Healthcare Provider Details

I. General information

NPI: 1265529986
Provider Name (Legal Business Name): VINCENT ANTHONY BELLAFIORE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CMR 466 MARIENHILLSTR 2-4
WUERZBURG BAVARIA
97074
DE

IV. Provider business mailing address

CMR 466 MARIENHILLSTR 2-4
WUERZBURG BAVARIA
97074
DE

V. Phone/Fax

Practice location:
  • Phone: 499318043883
  • Fax: 499318042274
Mailing address:
  • Phone: 499318043883
  • Fax: 499318042274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number042-0004327
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: