Healthcare Provider Details

I. General information

NPI: 1427378751
Provider Name (Legal Business Name): SUSAN R BELCHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN R GRIFFEE MD

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 MARKET PLACE RD
PENSACOLA FL
32504-8986
US

IV. Provider business mailing address

4901 MARKET PLACE RD
PENSACOLA FL
32504-8986
US

V. Phone/Fax

Practice location:
  • Phone: 850-484-4080
  • Fax: 850-484-8113
Mailing address:
  • Phone: 850-484-4080
  • Fax: 850-484-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME123709
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: