Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD13946 | RI |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD13946 | RI |
NPI | 1730379843 |
---|---|
Provider Name | Mr. Andrew E Burchard |
First Address | Providence, RI 02905-2403 |
Second Address | Providence, RI 02905-2403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 22/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1730379843 | (05) | RI |