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General NPI Number Information
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NPI Number | 1255397329
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Entity Type | Individual
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Provider Name | DAVID JOSEPH BELLWARE OD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 40520 CO HWY 34 WHITE EARTH HEALTH CENTER
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City | OGEMA
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State | MN
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Zip | 56569
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Country | US
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Telephone | 218-983-4300
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Fax | 218-983-6217
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Provider Business Mailing Address
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Address Line | 927 PEMBINA
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City | DETROIT LAKES
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State | MN
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Zip | 56501
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Country | US
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Telephone | 218-375-3600
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4725
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T1529
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1777
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2759
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License Number State | MN
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