Basic Information
| Provider Information | |||||||||
| NPI: | 1083157366 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELEMOU | ||||||||
| FirstName: | OUMOU | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1830 GOOD HOPE RD | ||||||||
| Address2: | |||||||||
| City: | ENOLA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170251233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179888135 | ||||||||
| FaxNumber: | 7172215600 | ||||||||
| Practice Location | |||||||||
| Address1: | 1830 GOOD HOPE RD | ||||||||
| Address2: | |||||||||
| City: | ENOLA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170251233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179888135 | ||||||||
| FaxNumber: | 7172215600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2016 | ||||||||
| LastUpdateDate: | 04/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | SC006703 | PA | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 213E00000X | SC006703 | PA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.