Provider Demographics
NPI:1821272386
Name:BELTZMAN, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:BELTZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 HOGBACK RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9752
Mailing Address - Country:US
Mailing Address - Phone:734-973-1020
Mailing Address - Fax:734-973-1074
Practice Address - Street 1:5328 FALKIRK CT
Practice Address - Street 2:
Practice Address - City:SUPERIOR TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48198-9652
Practice Address - Country:US
Practice Address - Phone:734-973-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010381932084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0814173OtherBLUE CROSS/BLUE SHIELD
MI0814173OtherBLUE CROSS/BLUE SHIELD
MIB47508Medicare UPIN