MEDICARE: BLANCHARD VALLEY PEDIATRICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician		OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891799789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLANCHARD VALLEY PEDIATRICS, INC.

Provider Business Mailing Address
First Line	:	1818 CHAPEL DR
Second Line	:	STE D
City	:	FINDLAY
State	:	OH
Zip	:	45840-1344
Country	:	US
Telephone Number	:	419-424-1922
Fax Number	:	419-424-1927

Provider Business Practice Location Address
First Line	:	1818 CHAPEL DR
Second Line	:	STE D
City	:	FINDLAY
State	:	OH
Zip	:	45840-1344
Country	:	US
Telephone Number	:	419-424-1922
Fax Number	:	419-424-1927

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT BECK
Credential	:	MD
Telephone Number	:	419-424-1922

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/21/2022

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