Provider Demographics
NPI:1255339248
Name:BELIVEAU, CAROLINE A (MD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:A
Last Name:BELIVEAU
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 1:484 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3704
Mailing Address - Country:US
Mailing Address - Phone:508-679-2555
Mailing Address - Fax:508-672-5442
Practice Address - Street 1:484 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3704
Practice Address - Country:US
Practice Address - Phone:508-679-2555
Practice Address - Fax:508-672-5442
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159503207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3200060Medicaid
MAA30524Medicare ID - Type Unspecified
H09462Medicare UPIN