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Individual

STANISLAV V BELYAEV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2003-0691
NM
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD2003-0691
NM
207RP1001X
Pulmonary Disease Physician
Primary
MD2003-0691
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
16500075
NM
01
324241YPPR
MEDICARE PTAN
NM
01
780148
MEDICARE PTAN / ROSWELL CLINIC CORP
NM
Enumeration date
09/29/2005
Last updated
09/14/2020
Update your record

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