Provider Demographics
NPI:1417128208
Name:BELOUD, BRETT R (MD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:R
Last Name:BELOUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17218 N 72ND DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8580
Mailing Address - Country:US
Mailing Address - Phone:623-334-8670
Mailing Address - Fax:623-334-8675
Practice Address - Street 1:17218 N 72ND DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8580
Practice Address - Country:US
Practice Address - Phone:623-334-8670
Practice Address - Fax:623-334-8675
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ32229207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine