Individual
MARK E BELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4199 GATEWAY BLVD, THE WOMENS HOSPITAL, NEWBURGH, IN 47630
(812) 842-4200
Mailing address
PO BOX 637275, CINCINNATI, OH 45263-0001
(812) 473-0181
(812) 473-5822
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01027503A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000359203
ANTHEM
IN
05
—
64752793
—
KY
01
—
P00253102
RAILROAD MEDICARE
—
Enumeration date
06/10/2006
Last updated
05/26/2011
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