Provider Demographics
NPI:1538373907
Name:BELLAM, NARESH (MD)
Entity type:Individual
Prefix:
First Name:NARESH
Middle Name:
Last Name:BELLAM
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 1:4145 CARMICHAEL RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-2803
Mailing Address - Country:US
Mailing Address - Phone:334-273-7000
Mailing Address - Fax:
Practice Address - Street 1:645 MCQUEEN SMITH ROAD
Practice Address - Street 2:SUITE 207
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7263
Practice Address - Country:US
Practice Address - Phone:334-351-1000
Practice Address - Fax:334-273-2228
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27885207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051598366OtherBCBS
AL110250Medicaid
AL051598364OtherBCBS
AL051598365OtherBCBS
AL110253Medicaid
ALP00829045OtherRAILROAD MEDICARE
AL110249Medicaid
AL51598191OtherBCBS
AL110251Medicaid
AL102I835106Medicare PIN