Provider Demographics
NPI:1972505618
Name:BELASCO, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:BELASCO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:207 N BROAD ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1500
Mailing Address - Country:US
Mailing Address - Phone:610-279-1370
Mailing Address - Fax:610-279-1372
Practice Address - Street 1:609 WEST GERMANTOWN PIKE
Practice Address - Street 2:MEDICAL ARTS BUILDING - SUITE #120
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403
Practice Address - Country:US
Practice Address - Phone:610-279-1370
Practice Address - Fax:610-279-1372
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD015526E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007360200019Medicaid
B33550Medicare UPIN
PA0007360200009Medicaid