Provider Demographics
NPI:1871580068
Name:BELCHER, JAMES EDWARD (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:BELCHER
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:PO BOX 23397
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3397
Mailing Address - Country:US
Mailing Address - Phone:314-299-2169
Mailing Address - Fax:314-558-8315
Practice Address - Street 1:10121 W FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-2103
Practice Address - Country:US
Practice Address - Phone:314-299-2169
Practice Address - Fax:314-558-8315
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4B50207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201538709Medicaid
MOA09993Medicare UPIN
MO016030001Medicare PIN