Provider Demographics
NPI:1669601456
Name:BELUE, MARGARET K (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:K
Last Name:BELUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:507 HARLEY STREET
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768
Mailing Address - Country:US
Mailing Address - Phone:256-259-0061
Mailing Address - Fax:256-259-0061
Practice Address - Street 1:507 HARLEY STREET
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768
Practice Address - Country:US
Practice Address - Phone:256-259-0061
Practice Address - Fax:256-259-0668
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN53111207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MNP01070634OtherRAILROAD MEDICARE
MNENROLLEDMedicaid