Healthcare Provider Details

I. General information

NPI: 1821078742
Provider Name (Legal Business Name): NORMAN BELAIR PA C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD STE 2670
NEWARK DE
19718-2200
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD STE 2670
NEWARK DE
19718-2200
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-2438
  • Fax:
Mailing address:
  • Phone: 302-733-2438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC50000107
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: