Organization
BELEZOS MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAS V BELEZOS MD (PRESIDENT)
(508) 765-4900
Entity
Organization
Contact information
Practice address
100 SOUTH ST, SUITE 107, SOUTHBRIDGE, MA 01550-4051
(508) 765-4900
(508) 765-4908
Mailing address
100 SOUTH ST, SUITE 107, SOUTHBRIDGE, MA 01550-4051
(508) 765-4900
(508) 765-4908
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
78702
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116881
FALLON
MA
01
—
651260
TUFTS
MA
05
—
9760211
—
MA
01
—
M19245
BLUE CROSS
MA
Enumeration date
12/12/2006
Last updated
08/22/2020
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