Healthcare Provider Details

I. General information

NPI: 1295833853
Provider Name (Legal Business Name): DEBORAH A BELCHIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 06/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 WILKENS AVE STE 208
BALTIMORE MD
21229-5265
US

IV. Provider business mailing address

3455 WILKENS AVE STE 208
BALTIMORE MD
21229-5265
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-4320
  • Fax:
Mailing address:
  • Phone: 410-644-4320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberD056369
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD056369
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License NumberD056369
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: