Healthcare Provider Details

I. General information

NPI: 1760690838
Provider Name (Legal Business Name): LAWRENCE JOSEPH BELLEW D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 SOCIETY DR
CLAYMONT DE
19703-1795
US

IV. Provider business mailing address

1202 SOCIETY DR
CLAYMONT DE
19703-1795
US

V. Phone/Fax

Practice location:
  • Phone: 302-791-0600
  • Fax:
Mailing address:
  • Phone: 302-791-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberC20003443
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: