Individual
MICHAEL BELLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1397 WEIMER RD, TAOS, NM 87571-2199
(505) 758-8883
(505) 751-5718
Mailing address
PO BOX DD, TAOS, NM 87571-2199
(505) 758-8883
(505) 751-5718
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H5538
—
NM
Enumeration date
04/28/2006
Last updated
08/13/2007
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