Provider Demographics
NPI:1811002637
Name:BURIK, DOUGLAS JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:JAMES
Last Name:BURIK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 CANTON ROAD NW
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615
Mailing Address - Country:US
Mailing Address - Phone:330-627-7112
Mailing Address - Fax:330-627-3876
Practice Address - Street 1:1244 CANTON ROAD NW
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615
Practice Address - Country:US
Practice Address - Phone:330-627-7112
Practice Address - Fax:330-627-3876
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000187268OtherANTHEM
OH0899550Medicaid
OH0899550Medicaid
U37177Medicare UPIN