Provider Demographics
NPI:1003915737
Name:BELCARZ, ERIK HENRY (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:HENRY
Last Name:BELCARZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 WOLVERINE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-6802
Mailing Address - Country:US
Mailing Address - Phone:734-624-2211
Mailing Address - Fax:
Practice Address - Street 1:29990 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3225
Practice Address - Country:US
Practice Address - Phone:248-538-6463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P27370023, N26930103Medicare PIN