| Burckhard Clinic, P. C. | |
|
315 Main St S Ste 315 Ste. 315 Minot ND 58701-3956 | |
| (701) 852-5876 | |
| (701) 852-5883 |
| Full Name | Burckhard Clinic, P. C. |
|---|---|
| Speciality | Clinic/Center |
| Location | 315 Main St S Ste 315, Minot, North Dakota |
| Authorized Official Name and Position | Mike V. Burckhard (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7018525876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Burckhard Clinic, P. C. 315 Main St S Ste 315 Ste. 315 Minot ND 58701-3956 Ph: (701) 852-5876 | Burckhard Clinic, P. C. 315 Main St S Ste 315 Ste. 315 Minot ND 58701-3956 Ph: (701) 852-5876 |
| NPI Number | 1346305190 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 11/19/2014 |
| Medicare PECOS PAC ID | 1850470972 |
|---|---|
| Medicare Enrollment ID | O20080430000793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346305190 | NPI | - | NPPES |
| 11482 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 120 (North Dakota) | Primary |
| Provider Name | Michael V Burckhard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104814789 PECOS PAC ID: 4082791579 Enrollment ID: I20080408000661 |
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