Provider Demographics
NPI:1255423448
Name:BELLE, CHERYL M (MD)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:M
Last Name:BELLE
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 1:2809 NORTH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-3647
Mailing Address - Country:US
Mailing Address - Phone:804-321-1400
Mailing Address - Fax:804-329-8461
Practice Address - Street 1:2809 NORTH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-3647
Practice Address - Country:US
Practice Address - Phone:804-321-1400
Practice Address - Fax:804-329-8461
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049033207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
234144OtherANTHEM ID
VA0101049033OtherSTATE ID
080007148OtherMEDICARE ID - SPECIFIED
23906OtherOPTIMA (SENTARA)
49D1042521OtherCLIA #
49D1042521OtherCLIA #
VA0101049033OtherSTATE ID