Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000690 | CT |
Y | 222Z00000X | Podiatrist | 000690 | CT |
NPI | 1053422634 |
---|---|
Provider Name | Dr. Stephen C. Burrows |
First Address | Fairfield, CT 06825-3220 |
Second Address | Fairfield, CT 06825-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U71537 | (02) | CT |