Provider Demographics
NPI:1386615060
Name:BELDEN, LEONA M (MD)
Entity type:Individual
Prefix:
First Name:LEONA
Middle Name:M
Last Name:BELDEN
Suffix:
Gender:F
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1085 NE GATEWAY CT NE
Practice Address - Street 2:STE 290
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2406
Practice Address - Country:US
Practice Address - Phone:704-403-4650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000890208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC260577OtherWELLPATH
NC891378KMedicaid
NC9181138OtherCIGNA HEALTHCARE
NC566000156OtherPIEDMONT PEDIATRIC TAX ID
NC1378KOtherBCBS
NC2129463OtherMAMSI
NCD7957OtherMEDCOST
NC7635172OtherAETNA
NC566000156OtherPIEDMONT PEDIATRIC TAX ID