Provider Demographics
NPI:1609826080
Name:BELLAMY, BART G (DO)
Entity Type:Individual
Prefix:
First Name:BART
Middle Name:G
Last Name:BELLAMY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6041 VILLAGE DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6619
Mailing Address - Country:US
Mailing Address - Phone:402-423-1382
Mailing Address - Fax:402-423-3590
Practice Address - Street 1:6041 VILLAGE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6619
Practice Address - Country:US
Practice Address - Phone:402-423-1382
Practice Address - Fax:402-423-3590
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025250200Medicaid
NEP00236017OtherMEDICARE TRAVELERS
NE92871Medicare UPIN
NE278792Medicare ID - Type Unspecified