Provider Demographics
NPI:1770773020
Name:BELCHER, JUSTIN MILES (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:MILES
Last Name:BELCHER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:333 CEDAR ST
Mailing Address - Street 2:BOARDMAN BUILDING #114 PO BOX 208056
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3206
Mailing Address - Country:US
Mailing Address - Phone:203-785-4184
Mailing Address - Fax:203-785-7068
Practice Address - Street 1:333 CEDAR ST
Practice Address - Street 2:BOARDMAN BUILDING #114
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3206
Practice Address - Country:US
Practice Address - Phone:203-785-4184
Practice Address - Fax:203-785-7068
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2014-09-29
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Provider Licenses
StateLicense IDTaxonomies
CT049325207RN0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist