Provider Demographics
NPI:1316448392
Name:BELLAMY, SPENCER EARL
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:EARL
Last Name:BELLAMY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1429
Mailing Address - Country:US
Mailing Address - Phone:804-668-8863
Mailing Address - Fax:
Practice Address - Street 1:3411 HOWARD RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1429
Practice Address - Country:US
Practice Address - Phone:804-398-1759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver