Provider Demographics
NPI:1083738785
Name:BELUK, SUSAN RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:RENEE
Last Name:BELUK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TOPPANS LN
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3863
Mailing Address - Country:US
Mailing Address - Phone:978-463-0029
Mailing Address - Fax:
Practice Address - Street 1:65 NEWBURYPORT TPKE
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:MA
Practice Address - Zip Code:01951-1113
Practice Address - Country:US
Practice Address - Phone:978-465-0779
Practice Address - Fax:978-465-9004
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59929207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ14254Medicare ID - Type Unspecified