Provider Demographics
NPI:1477524999
Name:HELTON, MARY BETH OGLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY BETH
Middle Name:OGLE
Last Name:HELTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2605 BLUE RIDGE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6678
Mailing Address - Country:US
Mailing Address - Phone:919-881-9009
Mailing Address - Fax:919-881-8463
Practice Address - Street 1:2605 BLUE RIDGE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6678
Practice Address - Country:US
Practice Address - Phone:919-881-9009
Practice Address - Fax:919-881-8463
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96003092080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891056MMedicaid
NC1056MOtherBLUECROSSBLUESHIELD INS
NC891056MMedicaid