Provider Demographics
NPI:1770793283
Name:BELLOTO, ROBERT JOHN JR (RPH, PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:BELLOTO
Suffix:JR
Gender:M
Credentials:RPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 QUEEN ELIZABETH CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-5716
Mailing Address - Country:US
Mailing Address - Phone:937-431-9047
Mailing Address - Fax:937-431-9048
Practice Address - Street 1:2508 QUEEN ELIZABETH CT
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-5716
Practice Address - Country:US
Practice Address - Phone:937-431-9047
Practice Address - Fax:937-431-9048
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-133471835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric