Healthcare Provider Details

I. General information

NPI: 1710484423
Provider Name (Legal Business Name): NICOLE BELKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 NEW HANOVER MEDICAL PARK DR
WILMINGTON NC
28403-5350
US

IV. Provider business mailing address

PO BOX 936857
ATLANTA GA
31193-6857
US

V. Phone/Fax

Practice location:
  • Phone: 910-662-8765
  • Fax: 910-362-9123
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number2025-03314
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: