Provider Demographics
NPI:1083090773
Name:BELEKANICH, ANTHONY MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:BELEKANICH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:NAVAL BRANCH HEALTH CLINIC EVERETT
Mailing Address - Street 2:2000 WEST MARINE VIEW DRIVE
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98207-0001
Mailing Address - Country:US
Mailing Address - Phone:425-304-4067
Mailing Address - Fax:
Practice Address - Street 1:NAVAL BRANCH HEALTH CLINIC EVERETT
Practice Address - Street 2:2000 WEST MARINE VIEW DRIVE
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98207-0001
Practice Address - Country:US
Practice Address - Phone:425-304-4067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003084152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist