MEDICARE: MRS. SANDRA L BELLIN 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	207V00000X	Obstetrics & Gynecology Physician	35055645B	OH

General Provider Information

NPI Number	:	1780674234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA L BELLIN MD

Provider Business Mailing Address
First Line	:	29001 CEDAR RD
Second Line	:	STE 518
City	:	LYNDHURST
State	:	OH
Zip	:	44124-4062
Country	:	US
Telephone Number	:	440-646-8200
Fax Number	:	440-646-8215

Provider Business Practice Location Address
First Line	:	29001 CEDAR RD
Second Line	:	STE 518
City	:	LYNDHURST
State	:	OH
Zip	:	44124-4062
Country	:	US
Telephone Number	:	440-646-8200
Fax Number	:	440-646-8215

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/08/2007

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