Individual
JACK E BELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
28080 GRAND RIVER AVE STE 306N, FARMINGTON HILLS, MI 48336-5966
(947) 521-8968
(248) 471-8061
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1862
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
5101006431
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21770011
—
MI
Enumeration date
12/29/2005
Last updated
07/21/2022
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