Healthcare Provider Details

I. General information

NPI: 1801909189
Provider Name (Legal Business Name): BURKHARD SPIEKERMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CONTINENTAL DR SUITE 412
NEWARK DE
19713-4306
US

IV. Provider business mailing address

111 CONTINENTAL DR SUITE 412
NEWARK DE
19713-4306
US

V. Phone/Fax

Practice location:
  • Phone: 302-709-4497
  • Fax: 302-733-0854
Mailing address:
  • Phone: 302-709-4497
  • Fax: 302-733-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101049314
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: