Individual
DR. BRUCE RAYMOND BELLEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2831 SKIMMERHORN ST, FORT COLLINS, CO 80526-6275
(970) 223-2274
Mailing address
2831 SKIMMERHORN ST, FORT COLLINS, CO 80526-6275
(970) 223-2274
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
21657
CO
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
9742
MT
208VP0000X
Pain Medicine Physician
21657
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01216571
—
CO
01
—
150115
WA L&I PROVIDER NUMBER
WA
Enumeration date
01/02/2007
Last updated
02/22/2010
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