MEDICARE: BELINDA JULIET CHAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	1025015	MA
2	207R00000X	Internal Medicine Physician	38053	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110009023	OTHER	CT	MEDICARE PROVIDER NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38053	OTHER	CT	CT STATE LICENSE

General Provider Information

NPI Number	:	1134154917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELINDA JULIET CHAN MD

Provider Business Mailing Address
First Line	:	50 STANIFORD ST STE 1000
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02114-2536
Country	:	US
Telephone Number	:	617-643-2132
Fax Number	:	617-724-2219

Provider Business Practice Location Address
First Line	:	50 STANIFORD ST STE 1000
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02114-2536
Country	:	US
Telephone Number	:	617-643-2132
Fax Number	:	617-724-2219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	03/17/2026

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