# BELVEDERE MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1619160835
- **Authorized official:** DR. GEORGE P BRANSCUM JR. MD (PRESIDENT)
- **Authorized official phone:** (717) 243-1515

## Contact information

- **Practice address:** 850 WALNUT BOTTOM ROAD, CARLISLE, PA 17013-3698
- **Practice address phone:** (717) 249-6073
- **Practice address fax:** (717) 218-3506
- **Mailing address:** 850 WALNUT BOTTOM ROAD, CARLISLE, PA 17013-3698
- **Mailing address phone:** (717) 249-6073
- **Mailing address fax:** (717) 218-3506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/21/2007
- **Last updated:** 03/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0006561610001 | — | PA |