Provider Demographics
NPI:1255499760
Name:BELDING, EDWARD (PT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:BELDING
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N TEJON ST
Mailing Address - Street 2:# 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1011
Mailing Address - Country:US
Mailing Address - Phone:719-381-4357
Mailing Address - Fax:719-381-4359
Practice Address - Street 1:525 N CASCADE AVE STE 1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3308
Practice Address - Country:US
Practice Address - Phone:719-381-4357
Practice Address - Fax:719-381-4359
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2468174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO803851Medicare PIN
CO803849Medicare PIN