Individual
DAVID JOSEPH BELLWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
40520 CO HWY 34, WHITE EARTH HEALTH CENTER, OGEMA, MN 56569
(218) 983-4300
(218) 983-6217
Mailing address
927 PEMBINA, DETROIT LAKES, MN 56501
(218) 375-3600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1777
TN
152W00000X
Optometrist
Primary
2759
MN
152W00000X
Optometrist
4725
OH
152W00000X
Optometrist
T1529
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2201833
MEDICA
—
01
—
39T60BE
BCBS
—
05
—
496820400
—
MN
01
—
585241029519
PREFERRED ONE
—
Enumeration date
04/26/2006
Last updated
05/04/2020
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