Provider Demographics
NPI:1952355463
Name:BELSON, SHELLY GREENBERG (MD)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:GREENBERG
Last Name:BELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 KENILWORTH AVE
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1339
Mailing Address - Country:US
Mailing Address - Phone:301-699-1882
Mailing Address - Fax:301-209-9456
Practice Address - Street 1:6510 KENILWORTH AVE
Practice Address - Street 2:SUITE 1300
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1339
Practice Address - Country:US
Practice Address - Phone:301-699-1882
Practice Address - Fax:301-209-9456
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040971207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG36455Medicare UPIN