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NPI Code Detail

MEDICARE: PETER BURNHAM

MEDICARE: PETER BURNHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLISW - 1844AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164467825
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER BURNHAM
Provider Business Mailing Address
First Line : 127 S 5TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85701-2005
Country : US
Telephone Number : 520-327-4505
Fax Number : 520-202-1889
Provider Business Practice Location Address
First Line : 127 S 5TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85701-2005
Country : US
Telephone Number : 520-327-4505
Fax Number : 520-202-1889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2006
Last Update Date : 07/09/2007

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Directions to “ PETER BURNHAM ” Practice Location

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