Provider Demographics
NPI:1710586615
Name:BURCHARD, BELINDA MAE
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:MAE
Last Name:BURCHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13778 FLINT RIDGE RD SE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43056-9048
Mailing Address - Country:US
Mailing Address - Phone:740-975-8211
Mailing Address - Fax:
Practice Address - Street 1:13778 FLINT RIDGE RD SE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43056-9048
Practice Address - Country:US
Practice Address - Phone:740-975-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2367040Medicaid