Provider Demographics
NPI:1427036953
Name:BELANGER, JULIE ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:BELANGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5430 ECHO RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6949
Mailing Address - Country:US
Mailing Address - Phone:919-741-7525
Mailing Address - Fax:252-756-8814
Practice Address - Street 1:518 GREENVILLE BLVD SE STE F
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-6758
Practice Address - Country:US
Practice Address - Phone:252-756-1078
Practice Address - Fax:252-756-8814
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2078152WC0802X, 152WP0200X, 152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC1929A314OtherMEDICARE PTAN