OrganizationMario O Belledonne PaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address8200 Tuckerman Ln, Potomac, MD 20854-3744(301) 605-7878PECOS EnrollmentBased on the most recent information from CMS, provider Mario O Belledonne Pa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1477855823Provider TypeOrganizationFull NameMario O Belledonne PaSubpartNoEnumeration Date11/17/2010Last Updated5/12/2021Contact InformationPractice LocationPractice Address8200 Tuckerman Ln, Potomac, MD 20854-3744Phone(301) 605-7878Fax(301) 605-7878Mailing LocationMailing Address8200 Tuckerman Ln, Potomac, MD 20854-3744Phone(301) 605-7878Fax(301) 605-7878Authorized OfficialNameBelledonne, Mario O (President)Phone(301) 605-7878Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseD-23177MarylandCode207RC0200XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseD-23177MarylandCode207RN0300XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseD-23177MarylandProvider IdentifiersIDDescriptionIssuerID6009-0001DescriptionOtherIssuerCAREFIRST BC/BSMarylandID4050855DescriptionOtherIssuerAETNAMarylandID272698DescriptionOtherIssuerTRICAREMarylandID323311100DescriptionMedicaidIssuerUnlistedMarylandID1020192DescriptionOtherIssuerCIGNAMarylandID127742DescriptionOtherIssuerJHMSC TRICAREMarylandID379065DescriptionOtherIssuerMAMSIMarylandID837442DescriptionOtherIssuerUHCMaryland