Basic Information
Provider Information
NPI: 1861473621
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BELOPOLSKY
FirstName: GERALD
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: PO BOX 55310
Address2: STATION MEDICAL CENTER
City: BIRMINGHAM
State: AL
PostalCode: 352555310
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 619 19TH ST S
Address2: STATION MEDICAL CENTER
City: BIRMINGHAM
State: AL
PostalCode: 352490001
CountryCode: US
TelephoneNumber: 2059344011
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/09/2005
LastUpdateDate: 05/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X29595ALY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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