Provider Demographics
NPI:1750812186
Name:BELAIR, STEPHEN (EMT)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:BELAIR
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14224 MCINTYRE RD
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-7296
Mailing Address - Country:US
Mailing Address - Phone:913-565-5901
Mailing Address - Fax:
Practice Address - Street 1:14224 MCINTYRE RD
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-7296
Practice Address - Country:US
Practice Address - Phone:913-565-5901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS48792146N00000X
E1632587146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic