Provider Demographics
NPI:1477527265
Name:BELISLE, ADELLE LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADELLE
Middle Name:LYNN
Last Name:BELISLE
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 1:1431 BATTERY CAULFIELD RD # B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-2293
Mailing Address - Country:US
Mailing Address - Phone:937-903-0746
Mailing Address - Fax:
Practice Address - Street 1:2351 CLAY STREET, SUITE 510
Practice Address - Street 2:SF SHOULDER, ELBOW & HAND CLINIC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-392-3225
Practice Address - Fax:415-928-1035
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041868207X00000X
CAC55055207X00000X
OH35091594207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery