Provider Demographics
NPI:1437153806
Name:BELLANTE, ANITA M (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:BELLANTE
Suffix:
Gender:F
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:PO BOX 638269
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5968
Mailing Address - Country:US
Mailing Address - Phone:330-952-2251
Mailing Address - Fax:
Practice Address - Street 1:3985 MEDINA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5968
Practice Address - Country:US
Practice Address - Phone:330-952-2251
Practice Address - Fax:330-952-2261
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-1140-B207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2485289Medicaid
I07868Medicare UPIN
OH2485289Medicaid
I07868Medicare UPIN
OH2485289Medicaid