# BELLEGROVE OB/GYN, INC. PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104931039
- **Authorized official:** MITCHELL E NUDELMAN MD (PRESIDENT)
- **Authorized official phone:** (425) 455-0244

## Contact information

- **Practice address:** 1200 112TH AVE NE STE C115, BELLEVUE, WA 98004-3745
- **Practice address phone:** (425) 455-0244
- **Practice address fax:** (425) 455-9411
- **Mailing address:** 1200 112TH AVE NE STE C115, BELLEVUE, WA 98004-3745
- **Mailing address phone:** (425) 455-0244
- **Mailing address fax:** (425) 455-9411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 600249764 | WA | — |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 05/11/2017