Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 28493 | WI |
Y | 208600000X | Surgeon | 28493 | WI |
N | 2086S0129X | Vascular Surgeon | 28493-020 | WI |
NPI | 1063492593 |
---|---|
Provider Name | James W Burhop |
First Address | Brookfield, WI 53005-4423 |
Second Address | Brookfield, WI 53005-4423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 16/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F18064 | (02) | WI |