Healthcare Provider Details

I. General information

NPI: 1730112996
Provider Name (Legal Business Name): MARK E BELEW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11125 DUNN RD STE 301
SAINT LOUIS MO
63136-6132
US

IV. Provider business mailing address

670 MASON RIDGE CENTER DR STE 300
SAINT LOUIS MO
63141-8573
US

V. Phone/Fax

Practice location:
  • Phone: 314-953-8250
  • Fax: 314-953-8255
Mailing address:
  • Phone: 314-953-8250
  • Fax: 314-953-8255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberR3P18
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: