Provider Demographics
NPI:1194050005
Name:BELUZO, WILLIAM ADAM III (RN)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ADAM
Last Name:BELUZO
Suffix:III
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 PURITAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-1056
Mailing Address - Country:US
Mailing Address - Phone:313-961-4722
Mailing Address - Fax:313-494-4120
Practice Address - Street 1:10001 PURITAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-1056
Practice Address - Country:US
Practice Address - Phone:313-961-4722
Practice Address - Fax:313-494-4120
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704198931163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health