Provider Demographics
NPI:1407847114
Name:BELL, DAVID S (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LYNDONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14098-9771
Mailing Address - Country:US
Mailing Address - Phone:585-765-2060
Mailing Address - Fax:585-765-2067
Practice Address - Street 1:77 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LYNDONVILLE
Practice Address - State:NY
Practice Address - Zip Code:14098-9771
Practice Address - Country:US
Practice Address - Phone:585-765-2060
Practice Address - Fax:585-765-2067
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00619310Medicaid
5999981OtherGHI
000507636003OtherCB/WNY
MDB811OtherPFC
0109101OtherIH
00010013801OtherUNIVERA
040426004304OtherFIDELIS/HRA
0488OtherBCBSR
NYB36082Medicare UPIN
0488OtherBCBSR