Provider Demographics
NPI:1417763970
Name:BELVIN, MAEGAN
Entity type:Individual
Prefix:
First Name:MAEGAN
Middle Name:
Last Name:BELVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 N 4030 RD
Mailing Address - Street 2:
Mailing Address - City:BOSWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74727-9242
Mailing Address - Country:US
Mailing Address - Phone:580-743-5673
Mailing Address - Fax:
Practice Address - Street 1:1008 N 4030 RD
Practice Address - Street 2:
Practice Address - City:BOSWELL
Practice Address - State:OK
Practice Address - Zip Code:74727-9242
Practice Address - Country:US
Practice Address - Phone:580-743-5673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist