Provider Demographics
NPI:1891995718
Name:CHAN, BELINDA MARIE (DPM)
Entity type:Individual
Prefix:DR
First Name:BELINDA
Middle Name:MARIE
Last Name:CHAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:BELINDA
Other - Last Name:DOTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:9145 N. DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414
Mailing Address - Country:US
Mailing Address - Phone:937-426-9500
Mailing Address - Fax:855-482-2337
Practice Address - Street 1:7111 N. MAIN STREET SUITE 60
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3142
Practice Address - Country:US
Practice Address - Phone:937-426-9500
Practice Address - Fax:855-482-2337
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003474213ES0103X
IL16005311213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery