Healthcare Provider Details

I. General information

NPI: 1508845934
Provider Name (Legal Business Name): RICHARD A BURGMEIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2177 E WARNER RD SUITE 105
TEMPE AZ
85284-3511
US

IV. Provider business mailing address

2177 E WARNER RD SUITE 105
TEMPE AZ
85284-3511
US

V. Phone/Fax

Practice location:
  • Phone: 480-897-3623
  • Fax:
Mailing address:
  • Phone: 480-897-3623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20130
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20130
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: