Provider Demographics
NPI:1528079274
Name:BELDE, DANIEL WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WILLIAM
Last Name:BELDE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26140 3RD ST E
Mailing Address - Street 2:
Mailing Address - City:ZIMMERMAN
Mailing Address - State:MN
Mailing Address - Zip Code:55398-9305
Mailing Address - Country:US
Mailing Address - Phone:763-458-7384
Mailing Address - Fax:
Practice Address - Street 1:211 S HWY 25
Practice Address - Street 2:PO BOX 717
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362
Practice Address - Country:US
Practice Address - Phone:763-295-4105
Practice Address - Fax:763-295-9116
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3757111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNV07627Medicare UPIN
MN350003525Medicare ID - Type Unspecified