MEDICARE: DR. GENEVIEVE M BELGRAVE M.D.

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	G7162	TX
2	174400000X	Specialist	G7162	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649200668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GENEVIEVE M BELGRAVE M.D.

Provider Business Mailing Address
First Line	:	7712 GRAND CANYON PL
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-3140
Country	:	US
Telephone Number	:	915-533-8499
Fax Number	:	915-544-4929

Provider Business Practice Location Address
First Line	:	1316 N YARBROUGH DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79925-7800
Country	:	US
Telephone Number	:	915-590-7378
Fax Number	:	915-590-7379

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/18/2024

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