Organization
MARIO O BELLEDONNE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO O BELLEDONNE MD (PRESIDENT)
(301) 605-7878
Entity
Organization
Contact information
Practice address
8200 TUCKERMAN LN, POTOMAC, MD 20854-3744
(301) 605-7878
(301) 605-7878
Mailing address
8200 TUCKERMAN LN, POTOMAC, MD 20854-3744
(301) 605-7878
(301) 605-7878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D-23177
MD
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D-23177
MD
207RN0300X
Nephrology Physician
D-23177
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1020192
CIGNA
MD
01
—
127742
JHMSC TRICARE
MD
01
—
272698
TRICARE
MD
05
—
323311100
—
MD
01
—
379065
MAMSI
MD
01
—
4050855
AETNA
MD
01
—
6009-0001
CAREFIRST BC/BS
MD
01
—
837442
UHC
MD
Enumeration date
11/17/2010
Last updated
05/12/2021
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