Basic Information
| Provider Information | |||||||||
| NPI: | 1255676037 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEBEDUM | ||||||||
| FirstName: | BELINDA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 638 W ORE ST | ||||||||
| Address2: | |||||||||
| City: | SEVEN VALLEYS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173609632 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 705 DIGITAL DR STE G | ||||||||
| Address2: | |||||||||
| City: | LINTHICUM HEIGHTS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210902267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139107900 | ||||||||
| FaxNumber: | 3125644059 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2012 | ||||||||
| LastUpdateDate: | 01/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 59916-20 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD468886 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 103699639 | 05 | PA | MEDICAID |