MEDICARE: GERALD BELOPOLSKY

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	207RP1001X	Pulmonary Disease Physician	29595	AL

General Provider Information

NPI Number	:	1861473621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD BELOPOLSKY

Provider Business Mailing Address
First Line	:	PO BOX 55310
Second Line	:	STATION MEDICAL CENTER
City	:	BIRMINGHAM
State	:	AL
Zip	:	35255-5310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 19TH ST S
Second Line	:	STATION MEDICAL CENTER
City	:	BIRMINGHAM
State	:	AL
Zip	:	35249-0001
Country	:	US
Telephone Number	:	205-934-4011
Fax Number	:

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	05/24/2021

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