Individual
YAKOV G BELENKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, RCS PROVIDER ENROLLMENT, MUNCIE, IN 47303-4988
(765) 254-4009
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01045443A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000347308
BLUE SHIELD - REID HOSP
IN
05
—
200112280
—
IN
05
—
2480524
—
OH
Enumeration date
09/15/2006
Last updated
07/30/2020
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