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General NPI Number Information
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NPI Number | 1912162850
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Entity Type | Organization
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Legal Business Name | VAN BUREN MEDICINE, LLC
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 320 N 32ND AVE
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City | PHOENIX
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State | AZ
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Zip | 85009-4220
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Country | US
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Telephone | 602-278-1351
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Fax | 602-278-4057
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Provider Business Mailing Address
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Address Line | 320 N 32ND AVE
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City | PHOENIX
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State | AZ
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Zip | 85009-4220
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Country | US
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Telephone | 602-278-1351
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Fax | 602-278-4057
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Authorized Official
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Title or Position | OWNER
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Name | JOHN M BELDEN
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Credential | D.O.
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Telephone | 602-278-1351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1645
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License Number State | AZ
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