MEDICARE: SHANDRA VICTORIA BELLINGER 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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1972291672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANDRA VICTORIA BELLINGER MD

Provider Business Mailing Address
First Line	:	3528 CONNOR PL
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-6902
Country	:	US
Telephone Number	:	301-728-1383
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 E 149TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5000
Fax Number	:

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

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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