Healthcare Provider Details

I. General information

NPI: 1285619858
Provider Name (Legal Business Name): CLIFFORD JOHN BELDEN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BROAD ST TEMPLE RADIOLOGY ASSOCIATES
PHILADELPHIA PA
19140-5103
US

IV. Provider business mailing address

1 MEDICAL CENTER DR
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 215-707-7237
  • Fax:
Mailing address:
  • Phone: 603-650-4671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number33876
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: