Healthcare Provider Details

I. General information

NPI: 1437147873
Provider Name (Legal Business Name): JONATHAN D BELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 FRANKLIN AVE SUITE 304
BERLIN MD
21811-1215
US

IV. Provider business mailing address

PO BOX 856
BERLIN MD
21811-0856
US

V. Phone/Fax

Practice location:
  • Phone: 410-629-1450
  • Fax: 410-629-1460
Mailing address:
  • Phone: 410-641-9450
  • Fax: 410-641-9515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0046255
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: