Provider Demographics
NPI:1821266198
Name:OCTAVIAN M. BELCEA, MD PA
Entity Type:Organization
Organization Name:OCTAVIAN M. BELCEA, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OCTAVIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELCEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:919-488-0111
Mailing Address - Street 1:2810 WAKEFIELD PINES DR STE 115
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-7078
Mailing Address - Country:US
Mailing Address - Phone:919-488-0111
Mailing Address - Fax:919-488-0104
Practice Address - Street 1:2810 WAKEFIELD PINES DR STE 115
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-7078
Practice Address - Country:US
Practice Address - Phone:919-488-0111
Practice Address - Fax:919-488-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
135J1OtherBCBS
NC5900499Medicaid
0299032OtherCIGNA
NC5900499Medicaid
135J1OtherBCBS