Healthcare Provider Details

I. General information

NPI: 1124139621
Provider Name (Legal Business Name): LEV BELDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 BUSTLETON AVE SUITE 100
PHILADELPHIA PA
19152-3328
US

IV. Provider business mailing address

12265 TOWNSEND RD SUITE 500
PHILADELPHIA PA
19154-1201
US

V. Phone/Fax

Practice location:
  • Phone: 215-543-0066
  • Fax: 215-543-0099
Mailing address:
  • Phone: 215-938-2040
  • Fax: 215-938-2042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS012357
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: