Provider Demographics
NPI:1750578175
Name:BELALCAZAR CANAL, JUAN CARLOS (MD)
Entity type:Individual
Prefix:
First Name:JUAN CARLOS
Middle Name:
Last Name:BELALCAZAR CANAL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 FORD PARKWAY, SAINT PAUL, MN
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116
Mailing Address - Country:US
Mailing Address - Phone:651-724-9411
Mailing Address - Fax:
Practice Address - Street 1:2277 FORD PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1817
Practice Address - Country:US
Practice Address - Phone:651-724-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-30
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN526432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry