DR. CHARLES G. BELLVILLE MD LLC NPI 1487931382

NPI Information

DR. CHARLES G. BELLVILLE, MD, LLC is an adult mental health clinic center in Portland, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. DR. CHARLES G. BELLVILLE, MD, LLC NPI is 1487931382. The provider is registered as an organization entity type.
The provider Is Doing Business As Charles G Bellville Sole Mbr.

The provider's business location address is:

909 SW SAINT CLAIR AVE
PORTLAND, OR
ZIP 97205-300
Phone: (503) 274-2661
Fax: (503) 692-0688

The provider's authorized official is Charles George Bellville .
The authorized official title is 0wner and has the following contact phone number (503) 274-2661.

The enumeration date for this NPI number is 11/8/2011 and was last updated on 8/16/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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