Provider Demographics
NPI:1831185891
Name:BELMONT, JONATHAN B (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:B
Last Name:BELMONT
Suffix:
Gender:
Credentials:MD
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Mailing Address - Street 1:124 DEKALB PIKE
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1853
Mailing Address - Country:US
Mailing Address - Phone:215-699-7600
Mailing Address - Fax:215-699-4758
Practice Address - Street 1:124 DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1853
Practice Address - Country:US
Practice Address - Phone:215-699-7600
Practice Address - Fax:215-699-4758
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD020680E207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0877064Medicaid
B35399Medicare UPIN
BE088875Medicare ID - Type Unspecified