Provider Demographics
NPI:1225017577
Name:BELLAND, KRIS MATTHEW (DO)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:MATTHEW
Last Name:BELLAND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 RIVERS AVE
Mailing Address - Street 2:NAVAL HOSPITAL CHARLESTON
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7747
Mailing Address - Country:US
Mailing Address - Phone:843-743-7961
Mailing Address - Fax:843-743-7930
Practice Address - Street 1:3600 RIVERS AVE
Practice Address - Street 2:NAVAL HOSPITAL CHARLESTON
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7747
Practice Address - Country:US
Practice Address - Phone:843-743-7961
Practice Address - Fax:843-743-7930
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine