Provider Demographics
NPI:1720380975
Name:BC PODIATRY PLLC
Entity Type:Organization
Organization Name:BC PODIATRY PLLC
Other - Org Name:GENTLE FOOT & ANKLE CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAN
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:BURKARDT
Authorized Official - Last Name:DPM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-308-2973
Mailing Address - Street 1:4123 MARTIN RD
Mailing Address - Street 2:STE 101
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-4151
Mailing Address - Country:US
Mailing Address - Phone:248-363-3777
Mailing Address - Fax:
Practice Address - Street 1:89 W SOUTH BLVD
Practice Address - Street 2:STE. 500
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1611
Practice Address - Country:US
Practice Address - Phone:248-509-7086
Practice Address - Fax:248-289-1853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-20
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6242670004OtherMEDICARE DMEPOS
MI480F337000OtherBLUE CARE NETWORK
480F394240OtherBLUE CROSS BLUE SHIELD
MI0P41010OtherMEDICARE
MI480F337000OtherBLUE CROSS BLUE SHIELD
MI480F337000OtherBLUE CROSS BLUE SHIELD
MIT34138Medicare UPIN