Provider Demographics
NPI:1255676037
Name:NEBEDUM, BELINDA (MD)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:NEBEDUM
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 1:3141 CAPE HORN RD
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-9071
Mailing Address - Country:US
Mailing Address - Phone:717-246-5180
Mailing Address - Fax:717-246-2005
Practice Address - Street 1:3141 CAPE HORN RD
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356-9071
Practice Address - Country:US
Practice Address - Phone:717-246-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD468886207R00000X
WI59916-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103699639Medicaid