Provider Demographics
NPI:1235137225
Name:CAROLINE BELIVEAU, MD, INC.
Entity Type:Organization
Organization Name:CAROLINE BELIVEAU, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELIVEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-679-2555
Mailing Address - Street 1:484 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3704
Mailing Address - Country:US
Mailing Address - Phone:508-679-2555
Mailing Address - Fax:508-672-5442
Practice Address - Street 1:484 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3704
Practice Address - Country:US
Practice Address - Phone:508-679-2555
Practice Address - Fax:508-672-5442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAG4-3582296207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9710710Medicaid
MAM21101Medicare ID - Type Unspecified