Healthcare Provider Details

I. General information

NPI: 1235137225
Provider Name (Legal Business Name): CAROLINE BELIVEAU, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 HIGHLAND AVE
FALL RIVER MA
02720-3704
US

IV. Provider business mailing address

484 HIGHLAND AVE
FALL RIVER MA
02720-3704
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-2555
  • Fax: 508-672-5442
Mailing address:
  • Phone: 508-679-2555
  • Fax: 508-672-5442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG4-3582296
License Number StateMA

VIII. Authorized Official

Name: CAROLINE A BELIVEAU
Title or Position: PRESIDENT
Credential: MD
Phone: 508-679-2555