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General NPI Number Information
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NPI Number | 1104894930
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Entity Type | Individual
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Provider Name | WILLIAM RICHARD BELTZ MD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 1100 GRAMPIAN BLVD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1909
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Country | US
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Telephone | 570-326-8550
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Fax | 570-326-8551
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Provider Business Mailing Address
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Address Line | 1201 GRAMPIAN BLVD SUITE 1K
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | MD019220E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD019220E
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License Number State | PA
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