Provider Demographics
NPI:1700864717
Name:BELL, IRA E III (MD)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:E
Last Name:BELL
Suffix:III
Gender:M
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 5007
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-5007
Mailing Address - Country:US
Mailing Address - Phone:336-882-1416
Mailing Address - Fax:336-882-8264
Practice Address - Street 1:1208 EASTCHESTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3170
Practice Address - Country:US
Practice Address - Phone:336-882-1416
Practice Address - Fax:336-882-8264
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC273592085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8914515Medicaid
NC14515OtherBCBSNC
NC8914515Medicaid
NC14515OtherBCBSNC