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NPI Code Detail

MEDICARE: STEPHEN DONALD BURCH

MEDICARE:   STEPHEN DONALD BURCH
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
1183500000XPharmacist22030NC

General Provider Information

NPI Number : 1760885834
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN DONALD BURCH
Provider Business Mailing Address
First Line : 1317 CAISTOR LN
Second Line :
City : RALEIGH
State : NC
Zip : 27614-7216
Country : US
Telephone Number : 479-461-3882
Fax Number : 919-803-1765
Provider Business Practice Location Address
First Line : 1317 CAISTOR LN
Second Line :
City : RALEIGH
State : NC
Zip : 27614-7216
Country : US
Telephone Number : 479-461-3882
Fax Number : 919-803-1765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2014
Last Update Date : 10/03/2014

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Directions to “ STEPHEN DONALD BURCH ” Practice Location

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