| Organization Name: | BELVEDERE MEDICAL CORPORATION |
| NPI Number: | 1013926757 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE P BRANSCUM (PRESIDENT) |
| Mailing Address: | 850 Walnut Bottom Road Ste 302 Carlisle |
| State: | PA US |
| Postal Code: | 170133698 |
| Phone Number: | 7172585150 |
| Fax Number: | 7172583392 |
| NPI Enumeration Date: | 08/05/2006 |
| NPI Last Update Date: | 11/02/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |