Provider Demographics
NPI:1851490999
Name:BELSON, ROGER ELLIOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:ELLIOTT
Last Name:BELSON
Suffix:
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 526
Mailing Address - Street 2:
Mailing Address - City:HENNIKER
Mailing Address - State:NH
Mailing Address - Zip Code:03242-0526
Mailing Address - Country:US
Mailing Address - Phone:603-428-3262
Mailing Address - Fax:
Practice Address - Street 1:14 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:HENNIKER
Practice Address - State:NH
Practice Address - Zip Code:03242-0526
Practice Address - Country:US
Practice Address - Phone:603-428-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D03372Medicare UPIN
BENH0076Medicare ID - Type Unspecified
NHNH0076Medicare PIN