Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | 42218 | NC |
NPI | 1255454468 |
---|---|
Provider Name | David Watkins Burke |
First Address | Morganton, NC 28680-3122 |
Second Address | Conover, NC 28613-8201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |