Provider Demographics
NPI:1902913387
Name:BELMAR, CARLOS J (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:J
Last Name:BELMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4214
Mailing Address - Country:US
Mailing Address - Phone:812-242-3005
Mailing Address - Fax:812-242-3054
Practice Address - Street 1:1725 N 5TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-4010
Practice Address - Country:US
Practice Address - Phone:812-242-3005
Practice Address - Fax:812-242-3054
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047399A207X00000X
IL36099107207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200149130Medicaid
IN200149130TMedicaid
351904269180OtherCARESOURCE MEDICAID
82816OtherCIGNA PCP PLAN
IN200149130WMedicaid
0182836OtherUS DEPT OF LABOR
339837OtherHEALTHLINK
INP00834673OtherRAILROAD MEDICARE
351904269139OtherCARESOURCE MEDICAID
N285392OtherHARMONY HEALTH PLAN IND
000000089594OtherANTHEM
IN200149130OOtherMOLINA HEALTHCARE MCAID
IN200149130ZMedicaid
G60390Medicare UPIN
IN200149130WMedicaid
ILL66674Medicare PIN
IN200149130ZMedicaid
0182836OtherUS DEPT OF LABOR
351904269180OtherCARESOURCE MEDICAID
339837OtherHEALTHLINK
IN200149130TMedicaid
IN192770BMedicare PIN