Basic Information
| Provider Information | |||||||||
| NPI: | 1902913387 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELMAR | ||||||||
| FirstName: | CARLOS | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 221 S 6TH ST | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478074214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122423005 | ||||||||
| FaxNumber: | 8122423054 | ||||||||
| Practice Location | |||||||||
| Address1: | 1725 N 5TH ST | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478044010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122423005 | ||||||||
| FaxNumber: | 8122423054 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 08/18/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 01047399A | IN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 36099107 | IL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 200149130 | 05 | IN | MEDICAID | 200149130T | 05 | IN | MEDICAID | 351904269180 | 01 | CARESOURCE MEDICAID | OTHER | 82816 | 01 | CIGNA PCP PLAN | OTHER | 200149130W | 05 | IN | MEDICAID | 0182836 | 01 | US DEPT OF LABOR | OTHER | 339837 | 01 | HEALTHLINK | OTHER | P00834673 | 01 | IN | RAILROAD MEDICARE | OTHER | 351904269139 | 01 | CARESOURCE MEDICAID | OTHER | N285392 | 01 | HARMONY HEALTH PLAN IND | OTHER | 000000089594 | 01 | ANTHEM | OTHER | 200149130O | 01 | IN | MOLINA HEALTHCARE MCAID | OTHER | 200149130Z | 05 | IN | MEDICAID |