| Mario O Belledonne PA | |
|
8200 Tuckerman Ln Potomac MD 20854-3744 | |
| (301) 605-7878 | |
| (301) 605-7878 |
| Full Name | Mario O Belledonne PA |
|---|---|
| Speciality | Internal Medicine |
| Location | 8200 Tuckerman Ln, Potomac, Maryland |
| Authorized Official Name and Position | Mario O Belledonne (PRESIDENT) |
| Authorized Official Contact | 3016057878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mario O Belledonne PA 8200 Tuckerman Ln Potomac MD 20854-3744 Ph: (301) 605-7878 | Mario O Belledonne PA 8200 Tuckerman Ln Potomac MD 20854-3744 Ph: (301) 605-7878 |
| NPI Number | 1477855823 |
|---|---|
| Provider Enumeration Date | 11/17/2010 |
| Last Update Date | 05/12/2021 |
| Certification Date | 05/12/2021 |
| Medicare PECOS PAC ID | 8426246588 |
|---|---|
| Medicare Enrollment ID | O20101216000587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477855823 | NPI | - | NPPES |
| 127742 | Other | MD | JHMSC TRICARE |
| 379065 | Other | MD | MAMSI |
| 837442 | Other | MD | UHC |
| 6009-0001 | Other | MD | CAREFIRST BC/BS |
| 272698 | Other | MD | TRICARE |
| 1020192 | Other | MD | CIGNA |
| 323311100 | Medicaid | MD | |
| 4050855 | Other | MD | AETNA |
| Provider Name | Mario O Belledonne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033129457 PECOS PAC ID: 4880882802 Enrollment ID: I20101220000747 |
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