Individual
ALEXANDRA BELLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1090 W PARK PL, COEUR D ALENE, ID 83814-2785
(208) 415-0299
(208) 625-2070
Mailing address
1919 LINCOLN WAY, COEUR D ALENE, ID 83814-2527
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14059
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14059
LICENSE
ID
Enumeration date
04/13/2016
Last updated
02/11/2020
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