Healthcare Provider Details

I. General information

NPI: 1659917961
Provider Name (Legal Business Name): BELCARA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1427 CLARKVIEW RD STE 300
BALTIMORE MD
21209-2100
US

IV. Provider business mailing address

1427 CLARKVIEW RD STE 300
BALTIMORE MD
21209-2100
US

V. Phone/Fax

Practice location:
  • Phone: 410-296-0414
  • Fax:
Mailing address:
  • Phone: 410-296-0414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHARI COHEN
Title or Position: COO
Credential:
Phone: 410-296-0414