Provider Demographics
NPI:1912013483
Name:DAVIDSON ROAD PRIMARY CARE, INC
Entity Type:Organization
Organization Name:DAVIDSON ROAD PRIMARY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURDA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-777-4544
Mailing Address - Street 1:4444 DAVIDSON RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9647
Mailing Address - Country:US
Mailing Address - Phone:614-777-4544
Mailing Address - Fax:614-771-5487
Practice Address - Street 1:4444 DAVIDSON RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9647
Practice Address - Country:US
Practice Address - Phone:614-777-4544
Practice Address - Fax:614-771-5487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center