Provider Demographics
NPI:1699721076
Name:BELATTI, RICHARD G JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:BELATTI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7837 CHICAGO PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3653
Mailing Address - Country:US
Mailing Address - Phone:402-390-6226
Mailing Address - Fax:402-390-6220
Practice Address - Street 1:7837 CHICAGO PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3653
Practice Address - Country:US
Practice Address - Phone:402-390-6226
Practice Address - Fax:402-390-6220
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16930208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078954313Medicaid
266718Medicare PIN
NED28445Medicare UPIN