Provider Demographics
NPI:1073177788
Name:BURKHART, NATALIE FAY (DO)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:FAY
Last Name:BURKHART
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:FAY
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:763 GREEN RIDGE DR E APT F
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2456
Mailing Address - Country:US
Mailing Address - Phone:574-268-8369
Mailing Address - Fax:
Practice Address - Street 1:714 N MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1035
Practice Address - Country:US
Practice Address - Phone:574-647-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02006834A207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine