Provider Demographics
NPI:1932246774
Name:BELLAMY, MICHAEL ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:BELLAMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 MEDICAL PARK DRIVE
Mailing Address - Street 2:WFUHS - LEXMEDICAL PEDIATRICS
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-6768
Mailing Address - Country:US
Mailing Address - Phone:336-243-4656
Mailing Address - Fax:336-243-4664
Practice Address - Street 1:8 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6768
Practice Address - Country:US
Practice Address - Phone:336-243-4911
Practice Address - Fax:336-249-1782
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY159936208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911065Medicaid
NCNC3621A569Medicare PIN