MEDICARE: IRA E BELL III 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	2085R0202X	Diagnostic Radiology Physician	27359	NC

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
2	14515	OTHER	NC	BCBSNC

General Provider Information

NPI Number	:	1700864717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRA E BELL III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 5007
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-5007
Country	:	US
Telephone Number	:	336-882-1416
Fax Number	:	336-882-8264

Provider Business Practice Location Address
First Line	:	1208 EASTCHESTER DR
Second Line	:	SUITE 200
City	:	HIGH POINT
State	:	NC
Zip	:	27265-3170
Country	:	US
Telephone Number	:	336-882-1416
Fax Number	:	336-882-8264

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	10/26/2007

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