=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760652960
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHERYL R BELLAIRE MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2008
-----------------------------------------------------
Last Update Date | 03/04/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 795 EAST MARSHALL STREET SUITE 304
-----------------------------------------------------
City | WEST CHESTER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19380
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-344-9095
-----------------------------------------------------
Fax | 610-344-9792
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 795 EAST MARSHALL STREET SUITE 304
-----------------------------------------------------
City | WEST CHESTER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19380
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-344-9095
-----------------------------------------------------
Fax | 610-344-9792
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHERYL RENEE BELLAIRE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 610-344-9095
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | MD057593L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------