Provider Demographics
NPI:1851707913
Name:COMMUNITY MEDICAL SPECIALISTS
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL SPECIALISTS
Other - Org Name:COMMUNITY FOOT SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:937-426-9500
Mailing Address - Street 1:3359 KEMP RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-4206
Mailing Address - Country:US
Mailing Address - Phone:937-426-9500
Mailing Address - Fax:855-482-2337
Practice Address - Street 1:3359 KEMP RD STE 100
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-4206
Practice Address - Country:US
Practice Address - Phone:937-426-9500
Practice Address - Fax:855-482-2337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003114261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3110261Medicaid
OH3110261Medicaid