Individual
HARITHA BELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,
Contact information
Practice address
5615 DEAUVILLE STE 240, MIDLAND, TX 79706-2709
(432) 221-5560
Mailing address
4214 ANDREWS HWY STE 240, MIDLAND, TX 79703-4817
(432) 221-5960
(432) 221-5981
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01069674A
IN
207RR0500X
Rheumatology Physician
Primary
P7070
TX
390200000X
Student in an Organized Health Care Education/Training Program
036.126660
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000734012
ANTHEM
IN
05
—
201037390
—
IN
01
—
415412YPVD
TX MEDICARE - PREMIER
TX
Enumeration date
11/01/2010
Last updated
05/05/2023
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