Provider Demographics
NPI:1215390943
Name:BELCHOS, JESSICA HELEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:HELEN
Last Name:BELCHOS
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 1:11541 E WINCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2040
Mailing Address - Country:US
Mailing Address - Phone:317-274-7827
Mailing Address - Fax:317-962-0289
Practice Address - Street 1:8240 NAAB RD STE 100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1985
Practice Address - Country:US
Practice Address - Phone:317-338-7450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN01080924A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program