Provider Demographics
NPI:1639124191
Name:BELLAIRE, BARBARA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANNE
Last Name:BELLAIRE
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 1:905 SW ORALABOR RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7004
Mailing Address - Country:US
Mailing Address - Phone:515-965-0300
Mailing Address - Fax:515-289-8554
Practice Address - Street 1:905 SW ORALABOR RD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7004
Practice Address - Country:US
Practice Address - Phone:515-965-0300
Practice Address - Fax:515-289-8554
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-36758207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1639124191Medicaid
IAP01202904OtherRR MEDICARE
LA05279Medicaid
IA0492520Medicaid
IA01492520Medicaid
IA01492520Medicaid
IAI17755Medicare PIN