Organization
EVAN T BELFER MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVAN T BELFER MD (PRESIDENT)
(618) 687-2319
Entity
Organization
Contact information
Practice address
801 N 14TH ST, MURPHYSBORO, IL 62966-1611
(618) 687-2319
(618) 684-3321
Mailing address
801 N 14TH ST, MURPHYSBORO, IL 62966-1611
(618) 687-2319
(618) 684-3321
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036-107906
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-107906
—
IL
01
—
039-32006
BLUECROSS BLUESHIELD
IL
01
—
078338
HEALTH ALLIANCE
IL
01
—
080191627
RAILROAD MEDICARE
IL
01
—
431741
HEALTHLINK
IL
01
—
614634500
DEPARTMENT OF LABOR
IL
Enumeration date
12/09/2010
Last updated
09/14/2011
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