Basic Information
| Provider Information | |||||||||
| NPI: | 1871973149 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELCHER | ||||||||
| FirstName: | SHAUNYE | ||||||||
| MiddleName: | MONIQUE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 DATA DR | ||||||||
| Address2: | |||||||||
| City: | RANCHO CORDOVA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956707956 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8220 WYMARK DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | ELK GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166670600 | ||||||||
| FaxNumber: | 9166830232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2015 | ||||||||
| LastUpdateDate: | 07/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4301107763 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A153694 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.