Provider Demographics
NPI:1285779207
Name:BELILES, KAREN (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BELILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 DEVILS REACH RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2806
Mailing Address - Country:US
Mailing Address - Phone:703-491-5165
Mailing Address - Fax:703-494-0698
Practice Address - Street 1:1308 DEVILS REACH RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2806
Practice Address - Country:US
Practice Address - Phone:703-491-5165
Practice Address - Fax:703-494-0698
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012308612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7115831Medicaid
VA7115831Medicaid
VA190001222Medicare PIN