Individual
BLAINE LANDON BURDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
675
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235393489
ND BLUE CROSS/SHIELD
ND
05
—
60678
—
ND
01
—
893212
ND VISION SERVICES
ND
Enumeration date
07/17/2008
Last updated
04/08/2010
Update your record
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