Provider Demographics
NPI:1083608392
Name:BELT, THOMAS G (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:BELT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 SHADELAND STATION
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3980
Mailing Address - Country:US
Mailing Address - Phone:317-579-2150
Mailing Address - Fax:317-579-2130
Practice Address - Street 1:7340 SHADELAND STATION
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3980
Practice Address - Country:US
Practice Address - Phone:317-579-2150
Practice Address - Fax:317-579-2130
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10327502085R0202X
IN01032750A2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00024128OtherRAILROAD MEDICARE PIN
IN000000109946OtherANTHEM
P00024118OtherRAILROAD MEDICARE PIN
P00024015OtherRAILROAD MEDICARE PIN
P00024124OtherRAILROAD MEDICARE PIN
P00024127OtherRAILROAD MEDICARE PIN
P00024422OtherRAILROAD MEDICARE PIN
P00023431OtherRAILROAD MEDICARE PIN
P00023650OtherRAILROAD MEDICARE PIN
P00024725OtherRAILROAD MEDICARE PIN
P00376931OtherRAILROAD MEDICARE PIN
IN100321230AMedicaid
P00023381OtherRAILROAD MEDICARE PIN
P00023638OtherRAILROAD MEDICARE PIN
P00024402OtherRAILROAD MEDICARE PIN
IN100321230AMedicaid
IN822400GMedicare PIN
P00024725OtherRAILROAD MEDICARE PIN
P00024422OtherRAILROAD MEDICARE PIN
P00024127OtherRAILROAD MEDICARE PIN