Healthcare Provider Details

I. General information

NPI: 1891799789
Provider Name (Legal Business Name): BLANCHARD VALLEY PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 CHAPEL DR STE D
FINDLAY OH
45840-1344
US

IV. Provider business mailing address

1818 CHAPEL DR STE D
FINDLAY OH
45840-1344
US

V. Phone/Fax

Practice location:
  • Phone: 419-424-1922
  • Fax: 419-424-1927
Mailing address:
  • Phone: 419-424-1922
  • Fax: 419-424-1927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: ROBERT BECK
Title or Position: PRESIDENT
Credential: MD
Phone: 419-424-1922