Gregorio M. Belloso M.D. P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D29505 Issued in MD

Legal business name

GREGORIO M. BELLOSO M.D. P.A.

Practice address

11974 Edgehill Terrace Rd
Princess Anne, MD 21853-2105

Phone

(410) 651-0011

NPI assigned

Apr 5, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gregorio M Belloso, MD

Title

Owner

Phone

(410) 341-6321

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1962791442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 CHINABERRY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218011265",
            "telephone_number": "410-341-6321",
            "fax_number": "410-341-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11974 EDGEHILL TERRACE RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218532105",
            "telephone_number": "410-651-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORIO M. BELLOSO M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "BELLOSO",
        "authorized_official_first_name": "GREGORIO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "14103416321",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D29505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46234",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michelle Grinberg, DMD
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• Kelly Lynn Haday, RDH

• Family Medicine Physician in Princess Anne, MD
• Providers in Princess Anne, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.