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Individual
GARY L BELANGER
Active
Individual
GARY L BELANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA279
AL
363A00000X
Physician Assistant
Primary
PA9106277
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051512155
BLUE CROSS BLUE SHIELD AL
AL
01
—
510-50070
BCBS OF ALABAMA
AL
05
—
528701110
—
AL
01
—
CA0084
RR MEDICARE
AL
Enumeration date
06/14/2006
Last updated
11/18/2011
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