Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 9600016 | NC |
Y | 207WX0107X | Retina Specialist | 9600016 | NC |
NPI | 1023078821 |
---|---|
Provider Name | Dr. Henry Warren Burnett |
First Address | Winston Salem, NC 27103-1958 |
Second Address | Winston Salem, NC 27103-1958 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 17/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8920027 | (05) | NC |
F24141 | (02) |