Provider Demographics
NPI:1396736104
Name:BELLWOAR, COLETTE F (DO)
Entity type:Individual
Prefix:DR
First Name:COLETTE
Middle Name:F
Last Name:BELLWOAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:804 SCOTT NIXON MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2464
Mailing Address - Country:US
Mailing Address - Phone:706-650-0705
Mailing Address - Fax:706-650-1034
Practice Address - Street 1:800 SPRUCE STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:215-427-5220
Practice Address - Fax:215-427-4339
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS007519L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ003558UMUMedicare PIN
PA785602N7NMedicare PIN
PAG9349Medicare UPIN